后入路腹腔镜治疗小儿肾盂输尿管连接部梗阻

Retroperitoneoscopic dismembered pyeloplasty in children

目的总结后入路腹腔镜下行肾盂成形术治疗小儿肾盂输尿管连接部(UPJ)梗阻的临床经验。方法采用后入路腹腔镜下施行离断性肾盂成形术治疗小儿UPJ梗阻21例,年龄3个月～12岁。经B超、静脉肾盂造影(IVU)和CT检查,21例患儿均有不同程度肾积水,梗阻位于肾盂输尿管连接处。结果21例UPJ梗阻患儿均取得满意的临床疗效。手术时间3.5～6.5h,平均5.3h。平均出血量42ml,平均术后住院时间5d。随访6～24个月,平均16个月,UPJ梗阻的症状均消失,影像学检查无梗阻。结论后入路腹腔镜下离断性肾盂成形术是治疗小儿UPJ梗阻安全、有效的方法,可以替代开放性手术。

Objective To report our experience of retroperitoneoscopic dismembered pyeloplasty in children.Methods Retroperitoneoscopic dismembered pyeloplasty was performed on 21 children of podiatric ureteropelvic junction(UPJ) obstruction,age ranging from 3 months to 12 years.All patients had radiographic evidence of obstruction.Results All of the 21 operations were performed successfully,and no serious complications occurred during and after the operations. Average operating time was 5.3 hours. Average blood loss was 42 ml.Mean postoperative stay was 5 d. With a mean follow-up of 16 months,all patients were free of obstruction on follow-up radiographic imaging.Conclusion Retroperitoneoscopic dismembered pyeloplasty is a safe and effective method for treatment of UPJ obstruction in children, and it can be used as an alternative to open surgery.