经腹入路3D腹腔镜联合输尿管硬镜同期处理肾盂输尿管连接部梗阻并肾盏结石的应用  

Application of laparoscopic pyeloplasty combined with ureteroscopy in the treatment of ureteropelvic junction obstruction complicated with calyx calculi

作　　者：汪帮琦 陈波特[1] 林浩坚 许晖阳 王镇伟 袁雪峰 林康健 邱晓拂[1] Bangqi Wang;Bote Chen;Haojian Lin;Huiyang Xu;Zhenwei Wang;Xuefeng Yuan;Kangjian Lin;Xiaofu Qiu(Department of Urology,Guangdong Second Provincial General Hosptial(Guangdong Provincial Emergency Hospital),Guangzhou,510317,China)

机构地区：[1]广东省第二人民医院(广东省应急医院)泌尿外科,广州510317

出　　处：《中华腔镜泌尿外科杂志（电子版）》2023年第6期597-600,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：广东省自然科学基金(2018A030313905);广州市科技计划项目(201904010035)。

摘　　要：目的探讨经腹入路3D腹腔镜联合输尿管硬镜在肾盂输尿管连接部梗阻并肾盏结石手术中的安全性及有效性。方法回顾性分析2019年12月至2022年1月广东省第二人民医院收治并手术的14例肾盂输尿管连接部梗阻并肾盏结石的患者临床资料,分析肾盏结石大小、结石数量、手术时间、术中失血量及一期结石清除率及手术效果。结果所有患者均采用经腹3D腹腔镜下肾盂离断成形术,术中输尿管镜经腔镜通道进入肾盂肾盏找到结石,取出结石。结石大小(0.89±0.32) cm,结石数量2~6枚,手术时间(138±18)min,术中失血量(12±5)ml,一期结石清除率100%,术后6~8周拔除输尿管支架管,术后3个月复查CT示肾积液缓解或消失,无肾结石复发及肾积液加重。结论3D腹腔镜联合输尿管硬镜在肾盂输尿管连接部梗阻并肾盏结石治疗中安全有效,具有创伤小,清石率高,是部分肾盂输尿管连接部梗阻合并肾盏结石患者治疗的良好选择。ObjectiveTo investigate the safety and efficacy of 3D laparoscopy combined with ureteroscopy in the treatment of ureteropelvic junction obstruction complicated with calyx calculi.MethodsThe clinical data of 14 patients with renal pelvic ureteral junction obstruction and renal calyx stones who were admitted and operated in Guangdong Second Provincial General Hosptial from December 2019 to January 2022 were analyzed retrospectively. The size of kidney stones, number of stones, operation time, intraoperative blood loss, and one-stage stone removal rate and surgical effect were collected and analyzed.ResultsAll patients underwent transabdominal 3D laparoscopic nephroplasty. The ureteroscope was placed in the renal pelvis and calyces through the laparoscopic channel to find and remove calyx stone. The mean stone size was (0.89±0.32) cm, the number of stones was 2-6, the operation time was (138±18) min, the intraoperative blood loss was (12±5) ml, the primary stone clearance rate was 100%, The ureteral stent was removed 6-8 weeks after operation, and CT scan revealed hydronephrosis significant reduced or disappeared 3 month after operation, and there was no recurrence of renal calculus or aggravation of hydronephrosis.Conclusion3D laparoscopy combined with rigid ureteroscopy is safe, effective, minimal invasive and has a high stone removal rate in the treatment of renal pelvic ureteral junction obstruction with calyx calculus, which is a good alternative therapy for partial UPJO with calyx calculi patients.

关 键 词：3D 腹腔镜 肾盂输尿管连接部梗阻 输尿管硬镜 肾盏结石 肾盂成形 

分 类 号：R699.2[医药卫生—泌尿科学]