腹腔镜辅助小切口肾盂成形术治疗小婴儿肾盂输尿管连接部梗阻

摘要

Objective:To sum up the experience of laparoscopic-assisted mini-incision dismembered pyeloplasty for infants with ureteropelvic junction obstruction (UPJO).Methods:From Oct.2009 to Aug.2012,a total of 16 infants with UPJO underwent mini-incision laparoscopic-assisted dismembered pyeloplasty.16 cases included 13 males and 3 females with the mean age of (3.9 ± 1.4)months.There were 12 cases of left unilateral UPJO,4 right unilateral UPJO.Their clinical data were retrospectively analyzed.Results:Sixteen operations were completed successfully.The operation time was (74.7 ± 10.6) min; There were no urinary fistula.Follow-upwas available in all the cases,B-ultrasonography showed that hydronephrosis decreased and renal pelvis width improved in all cases in postoperative 1,3 and 6 months.Conclusions:Laparoscopic-assisted small-incision pyeloplasty has the advantages of small incision,micro-invasion,little blood loss,short hospital stay and rapid recovery in the treatment of UPJO in infants compared with open surgery.Compared to laparoscopic pyeloplasty,it could make the procedure and anastomosis easier,reduce the time of operation and pneumoperitoneum,and decrease operative complications.%目的:总结腹腔镜辅助小切口离断性肾盂成形术治疗小婴儿肾盂输尿管连接部梗阻的手术方法与经验.方法:回顾分析2009年10月至2012年8月为16例小婴儿行腹腔镜辅助小切口离断性肾盂成形术的临床资料.其中男13例,女3例；平均(3.9±1.4)个月；左侧12例,右侧4例.结果:16例手术均顺利完成.手术时间平均(74.7±10.6)min；术后无一例发生尿漏.术后均获随访,术后1、3、6个月定期B超检查,肾积水均有一定程度改善,肾盂宽度较术前明显改善.结论:与开放手术相比,腹腔镜辅助小切口离断性肾盂成形术治疗小婴儿肾盂输尿管连接部梗阻具有患儿创伤小、出血少、住院时间短、术后康复快等优点；与腹腔镜肾盂成形术相比,具有缝合技术方面的优势,手术时间缩短,并发症发生率低.