机器人辅助腹腔镜下儿童肾盂成形术的初步探讨  

Preliminary results of robotic-assisted laparoscopic pyeloplasty in children

作　　者：吕逸清[1] 谢华[1] 黄轶晨[1] 许传亮[2] 余玲[1] 李晓溪[1] 陈艳[1] 丁志[1] 杨刚刚[1] 孙莉[1] 孙会振 陈方[1] 孙颖浩[2] 

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院泌尿外科,200053 [2]第二军医大学附属长海医院泌尿外科

出　　处：《中华泌尿外科杂志》2015年第10期721-725,共5页Chinese Journal of Urology

基　　金：上海市科学技术委员会科研计划项目（14411950403）

摘　　要：目的：总结机器人辅助腹腔镜下儿童肾盂成形术的经验，探讨此术式的疗效及安全性。方法回顾性分析2014年1—8月6例行达芬奇系统辅助腹腔镜下肾盂成形术（Anderson-Hynes术式）的患儿资料。6例均为男性，年龄4～12岁，平均9岁。患儿均经术前影像学检查诊断为肾盂输尿管连接处梗阻，狭窄均位于左侧。结果6例均在达芬奇系统辅助腹腔镜下顺利完成左侧肾盂成形术，术中无合并症，无中转开放手术。手术时间175～269min，平均216min，其中缝合时间30～60min，平均45min。估计出血量＜15ml。术后恢复良好，术后平均住院4．5d。出院后1个月拔除双J管。随访7～14个月，平均10个月，未发生狭窄复发、肾盂肾炎、肾萎缩等合并症。结论机器人辅助腹腔镜下肾盂成形术可以安全、有效地应用于4岁以上儿童肾盂输尿管连接处狭窄的治疗。Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty （ Anderson-Hynes ） at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years （ range 4 -12 years ） .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min （range 175-269 min）, with a mean robotic anastomosis time of 45 min （range 30-60 min）.Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months （ range 7 -14 months ） .There were no perioperative complications , and recovery was uncomplicated （without recurrence, pyelonephritis, nephrarctia） in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

关 键 词：儿童 机器人 腹腔镜 肾积水 肾盂输尿管连接处梗阻 

分 类 号：R726.9[医药卫生—儿科]