腹腔镜半肾输尿管切除术治疗成人重复肾(附15例报告)

Laparoscopic Heminephroureterectomy for the Treatment of Duplicated Kidney in Adults(A Report of 15 Cases)

目的探讨经腹腔入路腹腔镜半肾输尿管切除术治疗成人重复肾的手术方法和效果。方法采用经腹腔入路腹腔镜半肾输尿管切除术治疗成人上半重复肾患者15例。男5例,女10例,平均年龄28岁。左侧11例,右侧4例。观察手术时间,术中出血量和术中术后并发症及手术效果。结果 15例手术均成功。手术时间41～115 min,平均84 min。术中出血量5～150 ml,平均55 ml。术后住院时间4～8d,平均5.9d。术中和术后未出现明显并发症。随访3～24个月,平均15个月,下半肾功能良好。结论经腹腔入路腹腔镜半肾输尿管切除术治疗成人重复肾具有视野清晰,创伤小,出血少,恢复快,对下肾影响小等特点。

Objective To explore the technique and clinical efficacy of transperitoneal laparoscopic heminephroureterectomy for duplicated kidney in adults.Methods 15 patients with duplicated kidney underwent transperitoneal laparoscopic heminephroureterectomy.5 cases were male and 10 cases were female,the average age was 28 years old.11 cases were on the left side and 4 cases were on the right side.The operation time,estimated blood loss,intra and post operative complications and operative effects were recorded and analyzed.Results All procedures were successfully completed.The mean time of laparoscopic procedure was 84mins(range from 41 to 115mins).The mean intraoperative blood loss was 55ml(range from 5 to 150ml).The mean postoperative hospital time was 5.9 days(range from 4 to 8 days).No intraoperative and postoperative complications were found.The follow - up time ranged from 3 to 24 months(the mean follow - up time was 15 months) and the low pole renal function was normal.Conclusions Transperitoneal laparoscopic heminephroureterectomy for duplicated kidney were proved to be a technique with advantages of clear vision,minimally invasion,lower blood loss,faster recovery and minor impact on low pole kidney.