腹腔镜下乳头植入式输尿管膀胱再植术临床效果观察  

Clinical effect of laparoscopic direct nipple ureteroneocystostomy

作　　者：李海龙[1] 陈家存[1] 陈仁富[1] 李望[1] 温儒民[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,江苏徐州221002

出　　处：《临床泌尿外科杂志》2015年第12期1111-1113,共3页Journal of Clinical Urology

基　　金：国家自然科学基金项目(编号81502193);江苏省科技厅自然科学基金项目(编号BK20151167)

摘　　要：目的：观察腹腔镜下乳头植入式输尿管膀胱再植术治疗输尿管下段狭窄及先天性巨输尿管的临床效果。方法：2008年8月-2014年3月对12例输尿管下段狭窄及先天性巨输尿管患者实施腹腔镜下乳头植入式输尿管膀胱再植术。9例为单侧输尿管末端狭窄（左侧5例,右侧4例）;3例（4条）为先天性巨输尿管。观察手术时间、术中出血量、术后住院时间、并发症及手术疗效。结果：12例患者均成功完成腹腔镜下乳头植入式输尿管膀胱再植术,手术时间平均136min（58-250min）,术中出血量〈50ml,住院时间5-7d,术后1个月拔除双J管。术后患者腰痛症状即消失,随访3-48个月,B超及IVU提示肾积水消退,排空良好,未再发生狭窄;膀胱造影未见输尿管反流。结论：腹腔镜下乳头植入式输尿管膀胱再植术治疗输尿管末端狭窄及先天性巨输尿管是一种安全、有效的微创治疗方法。Objective： To explore the clinical effect of laparoscopic direct nipple ureteroneocystostomy in pa tients with distal-ureteral stenosis or primary obstructed megaureter. Method： From August 2008 to March 2014, 12 patients underwent laparoscopic direct nipple ureteroneocystostomy. Nine patients had unilateral distal-ureteral stenosis including five cases of left-sided distal-ureteral stenosis and four cases of right-sided. Other three patients were found primary obstructed megaureter. The operation time, estimated blood loss, postoperative hospital stay, complications and operative effect were recorded. Result： All the operations had been successfully performed. The mean operating time was 136 （range, 58-250） min. The mean intraoperative blood loss was less than 50 ml. The mean postoperative hospital stay was 6.5 （range, 5-7） d. After follow-up period of 3-48 months, B ultrasound and urography showed good clearance of the kidney and ureter, and cystography did not show any reflux. Conclusion; Laparoseopic direct nipple ureteroneocystostomy is a safe and effective technique with minimal invasion for distal-ureteral stenosis and primary obstructed megaureter.

关 键 词：腹腔镜 输尿管膀胱再植 

分 类 号：R699.4[医药卫生—泌尿科学]