腹腔镜下离断式肾盂成形术  

Transperitoneal laparoscopic dismembered pyeloplasty

作　　者：张大宏[1] 余大敏[1] 丁国庆[1] 陈岳兵[1] 李新德[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院泌尿外科,杭州310016

出　　处：《中华泌尿外科杂志》2004年第5期306-307,共2页Chinese Journal of Urology

摘　　要：目的　探讨腹腔镜下离断式肾盂成形术的临床疗效。　方法　采用经腹腔途径施行腹腔镜离断式肾盂成形术治疗输尿管肾盂连接部 (UPJ)梗阻 18例。男 11例 ,女 7例。B超提示重度积水 8例、中度 7例、轻度 3例。IVU显影良好 10例 ,显影差或不显影 8例。　结果　 18例手术均获成功。手术时间 10 0～ 2 10min ,平均 14 2min ;出血量 4 0～ 2 0 0ml。术后平均住院时间 7.4d。术后尿漏 1例。随访 3～ 12个月 ,UPJ吻合口无狭窄 ,肾积水减轻 ,中度积水 4例、轻度 7例、肾积水消失 7例 ;肾功能改善、IVU显影良好 14例 ,显影改善 4例。　结论　腹腔镜下离断式肾盂成形术是治疗UPJ梗阻的有效、可行的微创手术 ,可以替代开放手术。Objective To describe the new technique of transperitoneal laparoscopic dismembered pyeloplasty and to evaluate its clinical effect. Methods Of the 18 cases of ureteropelvic junction (UPJ) obstruction who underwent transperitoneal laparoscopic dismembered pyeloplasty,8 cases had severe hydronephrosis;7,intermediate;3,mild. Results Operations were all successful in 18 cases with the operating time being 100 to 210 min (mean,142 min) and the blood loss,40 to 200 ml.All the pores of puncture healed at phase 1;mean hospitalization was 7.4 d.Only 1 case had postoperative urine leakage.Follow-up of 3 to 12 months showed there was no stricture at UPJ and hydronephrosis was remitted (intermediate hydrops in 4 cases,mild in 7 and resolution in 7).The renal functions were improved. Conclusions Laparoscopic dismembered pyeloplasty is an effective and minimally invasive approach and can be used as an alternative to open surgery for UPJ obstruction.

关 键 词：腹腔镜手术 离断式肾盂成形术 肾积水 微创外科 输尿管肾盂连接部梗阻 

分 类 号：R699[医药卫生—泌尿科学]