CAJ | 학술논문

目的:探讨腹膜后腹腔镜离断性肾盂成形术治疗输尿管连接部梗阻(UPJO)的理论基础、手术技巧、临床效果及UPJO手术新进展.方法:回顾性分析经后腹腔镜肾盂成形术治疗的46例UPJO患者的临床资料.结果:手术时间75~400 min,平均186 min;术中出血量5~30 ml,平均20 ml;术后住院时间6~20 d,平均7.5 d.围手术期尿漏2例,1例因术后吻合口出血导致,1例因术后护理不当夹闭尿管造成,均保守治疗治愈.45例术后随访肾积水及肾功能均得到改善,1例患者因肾积水加重再次行开放性肾盂成形术.结论:经后腹腹腔镜下离断性肾盂成形术治疗初发UPJO具有安全、成功率高、无腹腔并发症等优点,可以进一步的推广和应用.后腹腔镜肾盂成形术能否用于第二次肾盂输尿管连接部梗阻的患者还需要进一步的探索.
목적:탐토복막후복강경리단성신우성형술치료수뇨관련접부경조(UPJO)적이론기출、수술기교、림상효과급UPJO수술신진전.방법:회고성분석경후복강경신우성형술치료적46례UPJO환자적림상자료.결과:수술시간75~400 min,평균186 min;술중출혈량5~30 ml,평균20 ml;술후주원시간6~20 d,평균7.5 d.위수술기뇨루2례,1례인술후문합구출혈도치,1례인술후호리불당협폐뇨관조성,균보수치료치유.45례술후수방신적수급신공능균득도개선,1례환자인신적수가중재차행개방성신우성형술.결론:경후복복강경하리단성신우성형술치료초발UPJO구유안전、성공솔고、무복강병발증등우점,가이진일보적추엄화응용.후복강경신우성형술능부용우제이차신우수뇨관련접부경조적환자환수요진일보적탐색.
Objective:To study theoretical basis,operation techniques and clinical effect for ureteropelvic junction obstruction by retroperitoneal laparoscopic dismembered pyeloplasty and to study surgery new progress of UPJO. Method:The clinical data of 46 patients with UPJO who underwent retroperitoneal laparoscopic pyeloplasty were retrospectively analyzed. Result:The mean operating time was 186 minutes(range from 75 to 400),the mean blood loss was 20 ml(range from 5 to 30),and the mean postoperative hospitalization days were 7.5 days(range from 6 to 20). Postoperative follow-up of hydronephrosis and renal function were improved. In peri operation period,two cases presented with urinary leakage,one because of postoperative anastomotic stoma bleeding,another improper nursing of closing catheter,two cases were cured by conservative treatment. 45 operations had been successful,hydronephrosis of one male patient was aggravated,which was operated by open pyeloplasty. Conclusion:Retroperitoneal laparoscopic pyeloplasty for primary UPJO has the advantages of security,high success rate and no abdominal complications etc,and can be further promotion and application. Whether retroperitoneal laparoscopic pyeloplasty can be used for the second UPJO also needs further exploration.