CAJ | 학술논문

目的探讨腹腔镜下治疗儿童输尿管多发息肉的手术技巧及其优势.方法回顾性分析13例儿童输尿管多发息肉所致肾积水的病例资料.男11例,女2例.年龄7.4～15.5岁,平均年龄11.4岁.左侧9例,右侧2例,双侧2例,共15侧.轻度积水9侧,中度4侧,重度2侧.所有病例均在腹腔镜下行患侧息肉切除术及肾盂输尿管成形术,术后B超或IVU随访.结果 12例在腹腔镜下顺利完成手术,1例中转开放.单侧手术时间70～152 min,平均时间90 min,术中失血20～40 ml.术后随访6～26个月,肾积水临床症状消失.13侧轻-中度肾积水消失,2侧重度积水明显减轻.静脉尿路造影提示无肾盂输尿管连接部梗阻及息肉复发.结论对于儿童输尿管多发息肉,腹腔镜是一种安全、有效、微创的外科手术方式.既具有完全切除病灶的优点,同时,较开放手术,也具有创伤小、出血少、术后恢复快、美观等微创手术优势.
목적 탐토복강경하치료인동수뇨관다발식육적수술기교급기우세.방법 회고성분석13례인동수뇨관다발식육소치신적수적병례자료.남11례,녀2례.년령7.4～15.5세,평균년령11.4세.좌측9례,우측2례,쌍측2례,공15측.경도적수9측,중도4측,중도2측.소유병례균재복강경하행환측식육절제술급신우수뇨관성형술,술후B초혹IVU수방.결과 12례재복강경하순리완성수술,1례중전개방.단측수술시간70～152 min,평균시간90 min,술중실혈20～40 ml.술후수방6～26개월,신적수림상증상소실.13측경-중도신적수소실,2측중도적수명현감경.정맥뇨로조영제시무신우수뇨관련접부경조급식육복발.결론 대우인동수뇨관다발식육,복강경시일충안전、유효、미창적외과수술방식.기구유완전절제병조적우점,동시,교개방수술,야구유창상소、출혈소、술후회복쾌、미관등미창수술우세.
Objective To describe and evaluate the surgical technique and advantage of laparoscopic management of pediatric ureteral polyp. Methods 11 boys and 2 girls with hydronephrosis caused by ureteral multiple polyps, who had undergone laparoscopic polypectomy and Anderson-Hynes pyeloplasty,were analyzed retrospectively. The ages of the patients ranged from 7.4 years to 15. 5 years, with a mean age of 11. 4 years. Of the 15 sides, left accounted for 9 cases, right for 2 cases and bilateral ones accounted for 2 cases. Among them, there were 9 mild,4,moderate,and 2 severe hydronephrosis. Postoperative follow-up with ultrasound and intravenous urography (IVU) was carried out in all patients. Results Laparoscopy was successfully completed in twelve patients. , One patient was converted to open operation. The unilateral duration of operations ranged from 90 min to 152 min,the mean times was 121 min A patient with bilateral pathologies was managed in single setting. The operation time was 185 minutes. Intraoperative blood lose was 20-40 ml. The follow-up duration ranged from six to 26 months. There was no clinical symptoms of hydronephrosis. Mild to moderate hydronephrosis in 13 sides disappeared. aTwo severe hydronephrosis was relieaved. No obstruction and recurrence of polyp were demonstrated by image studies. Conclusions Laparoscopic treatment of pediatric ureteral polyp can be performed safely, effectively with minimal invasiion. A clear visualization was provided for the complete polyp resection. It also provides all the benefits of minimally invasive surgery compared with open surgery,such as small incision,minimal blood lose,fast recovery and good cosmesis.