CAJ | 학술논문

目的评价后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部狭窄(UPJO)的临床效果.方法采用腹膜外路径对18例UPJO患者行离断式肾盂输尿管成形术.打开肾周筋膜,以肾下极为标志游离出肾盂输尿管连接部,切除狭窄部分,端端吻合肾盂输尿管并留置双J管.结果 18例患者手术全部成功,手术时间90～160 min,平均120 min；术中出血量50～110ml,平均80 ml；无严重并发症发生.术后住院7～12 d,平均8d.18例随访3～24个月,平均10个月；超声示肾积水均不同程度好转,16例静脉肾盂造影无吻合口狭窄.结论后腹腔镜下离断式肾盂输尿管成形术治疗UPJO有效、可行,可望成为肾盂输尿管连接部狭窄首选治疗方法.
목적 평개후복강경리단식신우성형술치료신우수뇨관련접부협착(UPJO)적림상효과.방법 채용복막외로경대18례UPJO환자행리단식신우수뇨관성형술.타개신주근막,이신하겁위표지유리출신우수뇨관련접부,절제협착부분,단단문합신우수뇨관병류치쌍J관.결과 18례환자수술전부성공,수술시간90～160 min,평균120 min；술중출혈량50～110ml,평균80 ml；무엄중병발증발생.술후주원7～12 d,평균8d.18례수방3～24개월,평균10개월；초성시신적수균불동정도호전,16례정맥신우조영무문합구협착.결론 후복강경하리단식신우수뇨관성형술치료UPJO유효、가행,가망성위신우수뇨관련접부협착수선치료방법.
Objective To evaluate the clinical efficacy of dismembered pyeloplasty assisted by retroperitoneal laparoscopy on ureteropelvic junction obstruction (UPJO).Methods A total of 18 patients with UPJO underwent dismembered pyeloplasty.During the operation,the fascia renalis wasopened and the reteropelvic junction obstruction was dissociated and dissected.The end-to-end anastomosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter.Results All the operations were performed successfully.The operation time was 90 - 160 min ( mean120 min),the blood loss was 50 - 110 ml (mean 80 ml ),and the postoperative hospitalization time 7 -12 d (mean 8 d).No severe complications occurred.Follow-up assessment with intravenous urography for 3 -24 months (mean 10 months) in 16 patients showed no ureteral stricture.Conclusions Dismebered pyeloplasty assisted by retroperitoneal laparoscopy is a method with little injury,effective and safe,and can become the first treatment method of ureteropelvic junction obstruction.