CAJ | 학술논문

在过去的20余年，用微创手段处理肾盂输尿管交界处狭窄技术得到了极大的发展。多个研究报告认为，无论经腹腔或腹膜后途径，腔镜下肾盂成形术在儿童和成人患者中均获得高成功率，且围手术期并发症低。腔镜下肾盂成形术最大的技术难点是腔内缝合，机器人辅助腔镜具有精细而灵活的机械臂、高放大倍数、三维视野及对手术器械抖动的控制等优点，使腔镜下缝合难题得到解决。腔镜下处理肾盂输尿管交界处狭窄最常采用肾盂输尿管离断成形术，其他术式如Fenger肾盂成形术，Y‐V肾盂成形术和“血管系住”技术在特定的群体可考虑选择。
재과거적20여년，용미창수단처리신우수뇨관교계처협착기술득도료겁대적발전。다개연구보고인위，무론경복강혹복막후도경，강경하신우성형술재인동화성인환자중균획득고성공솔，차위수술기병발증저。강경하신우성형술최대적기술난점시강내봉합，궤기인보조강경구유정세이령활적궤계비、고방대배수、삼유시야급대수술기계두동적공제등우점，사강경하봉합난제득도해결。강경하처리신우수뇨관교계처협착최상채용신우수뇨관리단성형술，기타술식여Fenger신우성형술，Y‐V신우성형술화“혈관계주”기술재특정적군체가고필선택。
ABSTRACT:Over the last two decades ,minimally invasive treatment options for ureteropelvic junction obstruction (UPJO) have been developed and popularized .Multiple series of laparoscopic pyeloplasty have demonstrated high success rates and low perioperative morbidity in pediatric and adult populations ,with both transperitoneal and retroperitoneal approaches .The evo‐lution of laparoscopy has been limited by the challenges of intracorporeal suturing . Robotic surgical systems may offer the means to overcome this major impediment of laparoscopic surgery .The gold standard surgical technique for the laparoscopic management of UPJO is dismembered pyeloplasty ,as described by Anderson and Hynes .However ,other techniques such as Fenger plasty ,Y‐V pyeloplasty ,or“Vascular Hitch” technique for UPJO repair can be considered whenever possible because they offers more advantages at no increased risk ,given a careful case selection ,mostly based on intraoperative findings .