CAJ | 학술논문

目的探讨腹膜后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部(UPJ)狭窄的操作技巧和临床效果.方法采用经后腹腔途径实施腹腔镜下离断式肾盂成形术治疗UPJ狭窄22例.男15例,女7例,年龄15～50岁.B超检查重度肾积水8例、中度12例、轻度2例.IVU检查:30min内显影良好8例,30～120min淡显影14例.结果 22例手术均获成功.手术时间80～155min,平均105min;出血量20～110 ml,平均45ml.术后住院时间5～11d,平均7.5 d.术后尿漏1例,保守治疗治愈;UPJ吻合口狭窄1例,输尿管镜扩张治愈.每3月复查IVU或B超,随访3～48个月,所有患者IVU检查肾功能显著改善,30min内显影良好18例,30～120min淡显影4例;B超检查肾积水消失7例,肾积水减轻13例,肾积水稳定2例.结论后腹腔镜下离断式肾盂成形术创伤小、操作不复杂、效果肯定,可望成为肾盂输尿管连接部狭窄首选治疗方法.
목적 탐토복막후복강경리단식신우성형술치료신우수뇨관련접부(UPJ)협착적조작기교화림상효과.방법 채용경후복강도경실시복강경하리단식신우성형술치료UPJ협착22례.남15례,녀7례,년령15～50세.B초검사중도신적수8례、중도12례、경도2례.IVU검사:30min내현영량호8례,30～120min담현영14례.결과 22례수술균획성공.수술시간80～155min,평균105min;출혈량20～110 ml,평균45ml.술후주원시간5～11d,평균7.5 d.술후뇨루1례,보수치료치유;UPJ문합구협착1례,수뇨관경확장치유.매3월복사IVU혹B초,수방3～48개월,소유환자IVU검사신공능현저개선,30min내현영량호18례,30～120min담현영4례;B초검사신적수소실7례,신적수감경13례,신적수은정2례.결론 후복강경하리단식신우성형술창상소、조작불복잡、효과긍정,가망성위신우수뇨관련접부협착수선치료방법.
Objectives To invetigate the oprating skills and clinical efficiency of dismembered pyeloplasty assisted by retroperitoneal laparoseopy for ureteropelvic junction(UPJ) obstruction. Methods 22 cases with UPJ were treated by dismembered pyeloplasty assisted by retroperitoneal laparoscopy. Among 22 cases ,15 cases were man and 7 cases were woman. The age were from 15 years old to 50 years old. 8 cases were serious hydronephrosis, 12 ca-ses were middle hydronephrosis and 2 cases were mild hydronephrosis by B ultrasonic. 8 cases had good vianllization in 30 min and 14 cases had low visullization in 30 ～ 20 min by IVU examination. Results 22 cases were operated successfully. The operating time were 80 ～155 min and the avaxage time was 105 min. The blood loss were 20 ～ 110ml and the avarnge was 45ml. The length of drainge and hospital stay were5 -11day and the avarage was 7.5d. 1 case occurred urinary leakage and was cured by traditional treatment. 1 case occurred anastonmotic stricture and was cured by ureteroscopy dilatation. 22 cases were examined by IVU and B ultrasonic every 3 months and were followed 3 ～48 months. The renal function of all of the cases were obviously improved by IVU and 18 cases had good visulliza-tion in 30 min and 4 cases had low visullization in 30 ～ 120 min. Hydronephrosis disappeared in 7 cases,decreased in 13 cases and stabilized in 2 cases by B ultrasonic examination. Conclusions Dismembered pyeloplasty assisted by retroperitoneal laparoscopy are little injury, simple operation and effective and can become the first treatment method of ureteropelvic junction obstruction.