腹腔镜游离性输尿管膀胱再植术的临床应用

Laparoscopic free ureteral reimplantation

目的探讨腹腔镜游离性输尿管膀胱再植术的适应证、手术技巧及其应用效果。方法应用腹腔镜游离性输尿管膀胱再植术治疗21例输尿管末端狭窄患者。结果21例均获得成功。手术时间60～180min，平均110min，术中出血40～120ml，住院3～7d。随访3～24个月，B超和静脉肾盂造影显示，肾输尿管积水消失或好转，膀胱造影检查未见输尿管反流发生。结论腹腔镜游离性输尿管膀胱再植术不仅操作简单、手术创伤小，而且患者恢复快、抗反流效果好。

[Objective] To introduce the new technique of transperitoneal laparoscopic free ureteral reimplantation and to evaluate its feasibility and clinical significance.[Methods] 17 cases of ureterovesical obstruction were operated with transperitoneal laparoscopic free ureteral reimplantation.[Results] The operations were all successful in 17 cases with operating time of 60~180 min(mean 110 min) and blood loss of 40～(120 ml.)The patients were discharged 3～7 days after surgery.During 3～24 months'follow-up,ultrasound B and IVU showed moderate or mild hydronephrosis in 12 cases and no obvious hydronephrosis in 9 cases.3~24 months after surgery cystography showed no urine reflux in all cases.[Conclusions] Laparoscopic free ureteral reimplantation is a feasible,less painful and minimally invasive alternative method for treatment of Ureterovesical junction obstruction diseases.