中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
6期
373-375
,共3页
孟小鑫%殷长军%吕强%华立新%王增军%顾民%邵鹏飞%张炜%徐正铨%眭元庚
孟小鑫%慇長軍%呂彊%華立新%王增軍%顧民%邵鵬飛%張煒%徐正銓%眭元庚
맹소흠%은장군%려강%화립신%왕증군%고민%소붕비%장위%서정전%휴원경
腹腔镜%肾盂输尿管连接部狭窄
腹腔鏡%腎盂輸尿管連接部狹窄
복강경%신우수뇨관련접부협착
Laparoscopes%Ureteropelvic junction obstruction
目的 评价腹腔镜下手术治疗肾盂输尿管连接部狭窄梗阻(UPJO)的疗效.方法 UPJO患者102例.男56例,女46例.平均年龄31(6～62)岁.左侧53例,右侧49例.102例均经临床及影像学检查证实.肾盂分离平均28(20～46)mm,重度积水21例、中度63例、轻度18例.采用腹膜后径路行离断式肾盂输尿管成形术.术中打开肾周筋膜,以肾下极为标志游离出肾盂输尿管连接部,切除狭窄部分,肾盂输尿管端端连续吻合并留置双J管.结果 102例手术均成功.手术时间平均120(70～180)min,术中出血量平均80(50～100)ml.无严重并发症发生.术后住院平均8.5(6～14)d.102例随访平均9(3～15)个月,经B超复查肾积水消失30例,72例肾盂分离较术前平均减少12(8～26)mm.IVU检查85例吻合口无狭窄.结论 腹腔镜下离断式肾盂输尿管成形术治疗UPJO有效、可行,可以替代开放手术.
目的 評價腹腔鏡下手術治療腎盂輸尿管連接部狹窄梗阻(UPJO)的療效.方法 UPJO患者102例.男56例,女46例.平均年齡31(6～62)歲.左側53例,右側49例.102例均經臨床及影像學檢查證實.腎盂分離平均28(20～46)mm,重度積水21例、中度63例、輕度18例.採用腹膜後徑路行離斷式腎盂輸尿管成形術.術中打開腎週觔膜,以腎下極為標誌遊離齣腎盂輸尿管連接部,切除狹窄部分,腎盂輸尿管耑耑連續吻閤併留置雙J管.結果 102例手術均成功.手術時間平均120(70～180)min,術中齣血量平均80(50～100)ml.無嚴重併髮癥髮生.術後住院平均8.5(6～14)d.102例隨訪平均9(3～15)箇月,經B超複查腎積水消失30例,72例腎盂分離較術前平均減少12(8～26)mm.IVU檢查85例吻閤口無狹窄.結論 腹腔鏡下離斷式腎盂輸尿管成形術治療UPJO有效、可行,可以替代開放手術.
목적 평개복강경하수술치료신우수뇨관련접부협착경조(UPJO)적료효.방법 UPJO환자102례.남56례,녀46례.평균년령31(6～62)세.좌측53례,우측49례.102례균경림상급영상학검사증실.신우분리평균28(20～46)mm,중도적수21례、중도63례、경도18례.채용복막후경로행리단식신우수뇨관성형술.술중타개신주근막,이신하겁위표지유리출신우수뇨관련접부,절제협착부분,신우수뇨관단단련속문합병류치쌍J관.결과 102례수술균성공.수술시간평균120(70～180)min,술중출혈량평균80(50～100)ml.무엄중병발증발생.술후주원평균8.5(6～14)d.102례수방평균9(3～15)개월,경B초복사신적수소실30례,72례신우분리교술전평균감소12(8～26)mm.IVU검사85례문합구무협착.결론 복강경하리단식신우수뇨관성형술치료UPJO유효、가행,가이체대개방수술.
Objective To discuss the treatment of ureteropelvic junction obstruction by laparoscopic pyeloplasty. Methods A retrospective review of consecutive laparoscopic pyeloplasty in 102 patients between September 2001 and December 2007 was performed. The ureterpelvic junction was dissected and the obstruction portion was excised. Anastomosis was then performed through the ureter and the renal pelvis walls with a stent. Results The mean operating time was 120 min and the average blood loss was 80ml. No major complication occurred intraoperative. The drainage was removed in 3-10 days. The average hospital stay was 8.5 days. The stent was kept for 30-60 days. IVU and B ultrasound examination revealed that the hydronephrosis alleviated during the follow-up and no anastomosis stricture occurred. Conclusions Laparoscopic dismembered pyeloplasty could provide lower morbidity, shorter hospital stay, and faster convalescence. It could be an effective treatment for ureteropelvic junction obstruction.
