腹膜后腹腔镜离断性肾盂成形术治疗肾盂输尿管连接部梗阻(附22例报告)

摘要

Objective:To summarize the experiences of retroperitoneoscopic dismembered pyeloplasty for treatment of ureteropelvic junction obstruction in order to improve the technique. Methods: Clinical data of 22 patients with ureteropelvic junction obstruction underwent retroperitoneoscopic dismembered pyeloplasty were analyzed retrospectively. The age ranged from 15 to 33 years. All patients had radiographic evidence of obstruction with deterioration of renal function and ydronephrosis. Results;All 22 operations were performed successfully, and no serious complications occurred during and after the operations. The mean operating time was ( 150± 12. 6) min,the mean blood loss was (60 ± 10. 7) ml. The mean postoperative hospital stay was (6. 5 ±1.5) d. With a follow-up of 3-24 months,no stenosis could be noted at the anastomosis,and hydronephrosis resolved and renal function improved. Conclusions:Retroperitoneoscopic dismembered pyeloplasty is a safe and effective minimally invasive procedure in the treatment of ureteropelvic junction obstruction, and it can replace the open surgery.%目的:总结腹膜后腹腔镜离断性肾盂成形术治疗肾盂输尿管连接部梗阻(ureteropelvic junction obstruction,UPJO)的手术经验,以提高其手术技巧.方法:回顾分析为22例UPJO患者行腹腔镜离断性肾孟成形术的临床资料.术前均经影像学检查证实UPJO,并伴有不同程度的肾积水.结果:22例手术均获成功.手术时间平均(150 ± 12.6) min,术中出血量平均(60±10.7) ml,术后平均住院(6.5±1.5)d,无并发症发生.随访3～24个月,手术侧肾盂输尿管连接部吻合口无狭窄,肾盂输尿管排尿功能好.结论:腹膜后腹腔镜离断性肾盂成形术治疗UPJO安全、有效,有望逐步替代开放性手术.