儿童肾盂输尿管连接部狭窄的后腹腔镜手术及并发症处理  

Retroperitoneal Laparoscopic Surgery and Complications of Children With Renal Pelvis and Ureter Junction Stenosis

作　　者：张二伟[1] 张雪培[1] 王声政[1] 张海波[1] 可方 师文强[1] 陶金[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《中国继续医学教育》2016年第20期112-113,共2页China Continuing Medical Education

摘　　要：目的 总结后腹腔镜治疗儿童肾盂输尿管连接部狭窄的安全性、手术技巧及术后并发证的处理。方法 回顾分析总结后腹腔镜微创手术治疗的60例儿童肾盂输尿管连接部狭窄患者的手术相关情况,术后并发症处理及术后随访情况特征。结果 60例患者手术均成功,无中转开腹。57例为离断再吻合,3例Y-V吻合,手术时间41-92 min,平均（65.2±2.1）min,术中出血平均（17.5±1.2）ml。术中注意避免钳夹输尿管,可通过牵引标志线或游离肾脏调整缝合方向至合适角度,术后平均住院（7.9±0.8）d。术后发生漏尿2例,均通过肾脏穿刺后治愈。无其他并发症,术后半年复查静脉肾盂造影,患者连接部狭窄均治愈,肾积水程度减轻。结论 后腹腔镜肾盂成形治疗儿童肾盂输尿管连接部狭窄安全有效。大部分需离断再吻合。术后发生漏尿可通过经皮肾穿刺引流治愈。Objective To summarize the safety of retroperitoneal laparoscopic pyeloplasty, and techniques in operation and treatment of complication after operation. Methods Retrospectively analysis operation parametres operation techniques and surgery complications of 60 cases of retroperitoneal laparoscopic pyeloplasty in children with renal pelvis and ureter junction stenosis. Results All the cases were successful, among them 57 cases were dismembered surgery and then anastomosis and 3 cases of Y plasty, the average time of operation was 41 to 92minutes and average was （65.2±2.1）minutes, the average bleeding was （17.5±1.2） ml. The average hospital stay was（7.9±0.8）days after operation. There were 2 cases of urinary leakage after operation, all patients were cured by renal puncture without any other complication. The six monthes postsurgery IVP shown that they were totally cured. Conclusion The retroperitoneal laparoscopic pyeloplasty operation is safe in child. Most of them need dismembered surgery. Postoperative urinary leakage can be cured by percutaneous renal puncture and drainage.

关 键 词：肾盂输尿管连接部狭窄 后腹腔镜肾盂成形 并发症 

分 类 号：R979.5[医药卫生—药品]