离断式与非离断式肾盂瓣肾盂成形术:探索与进展  

Review of the exploration and progress in dismembered and non-dismembered flap pyeloplasty

作　　者：刘畅[1] 王冰[2] 杨昆霖 李学松[1] LIU Chang;WANG Bing;YANG Kunlin;LI Xuesong(Department of Urology,Peking University First Hospital,Institute of Urology,Peking University,National Urological Cancer Center,Beijing 100034;Department of Urology,Peking University First Hospital-Miyun Hospital,Beijing 101599,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系统肿瘤中心,北京100034 [2]北京大学第一医院密云医院泌尿外科,北京101599

出　　处：《现代泌尿外科杂志》2024年第1期5-11,共7页Journal of Modern Urology

摘　　要：肾盂输尿管连接部梗阻(UPJO)是以肾脏至输尿管尿液流出受阻为特征的疾病。随着腔镜技术发展,机器人辅助的腹腔镜下离断式肾盂成形术是目前主流的手术治疗方式。接受肾盂成型术治疗的患者中仍有约10%会治疗失败,此类患者常伴有长段的近端输尿管狭窄(长度>2 cm),再次手术难度和失败风险显著增加。既往需通过回肠代输尿管手术或自体肾移植手术来替代或弥补输尿管的长段缺损,然而此类术式术后并发症较多,多数情况下并不被作为首选。肾盂瓣技术使用患者自身扩大的肾盂壁为材料,能够连接较长段的输尿管缺损,是针对这一难题的良好解决方案。本文回顾了现有文献中对于肾盂瓣肾盂成形术的具体应用,并总结了本中心肾盂瓣肾盂成形术的技术改进及研究进展,为临床应用提供参考。Ureteropelvic junction obstruction(UPJO)is a condition characterized by the blockage of urine flow from the kidney to the ureter.With advancements in endoscopic technology,robotic-assisted laparoscopic dismembered pyeloplasty has become the dominant approach.However,approximately 10%of patients who undergo pyeloplasty still experience treatment failure,often due to long-segment proximal ureteral strictures(length greater than 2 cm).This increases the difficulty and risk of subsequent surgeries.In the past,ileal ureter replacement or kidney autotransplantation procedures were used as alternatives to shorten or replace the ureter.However,these procedures are associated with metabolic and vascular complications and are not always preferred.A pelvic flap,which utilizes the enlarged wall of the renal pelvis,is a good solution for bridging longer segments of a diseased ureter.This article reviews the specific applications of pelvic flap pyeloplasty in the existing literature and summarizes the technical improvements and research progress of renal pelvic flap pyeloplasty in our center to provide a reference for clinical application.

关 键 词：肾盂瓣 肾盂成形术 肾盂输尿管连接部梗阻 输尿管狭窄 

分 类 号：R693.2[医药卫生—泌尿科学]