腹腔镜辅助下离断式反向裁剪肾盂成形术13例

Laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction: Report of 13 cases

目的探讨腹腔镜辅助下结合放大镜行离断式肾盂成形术可行性。方法肾盂输尿管连接部狭窄13例采用腹膜后小切口，腹腔镜下游离肾周围，肾盂及输尿管上段，将肾盂反向裁剪，放大镜下行肾盂输尿管吻合。结果13例手术均获成功，手术时间100～180min，平均121min，术中出血量30～100ml，平均70ml。12例随访3～20个月，平均12．3月，肾功能恢复良好，肾积水基本消失。结论腹腔镜下离断式反向裁剪肾盂成形术符合解剖生理，临床可行，值得推广。

Objective To evaluate the feasibility of laparoscopically assisted dismembered pyeloplasty without the V - flap reconstruction. Methods A total of 13 cases of ureteropelvic junction obstruction （UPJO） underwent laparoscopically assisted dismembered pyelopasty via a small incision through the retroperitoneal approach without the V - flap pyeloplasty technique. After exposing the proximal ureter and renal pelvis to identify the UPJ obstruction, the UPJ area is then excised and the apex of the ureter is then anastomosed to the most inferior aspect of the renal pelvis. Results All the operations bad been successfully completed. The operating time was 100 - 180 rain （mean, 121 min） , and the intraoperative blood loss, 30 - 100 ml （mean, 70 ml）. Follow -up for 3 -20 months （mean, 12.3 months） in 12 cases revealed a full recovery of renal functions and disappearance of hydronephrosis. Conclusions Laparoscopically assisted dismembered pyeloplasty without the V -flap reconstruction is feasible in the treatment of U PIO.