后腹腔镜技术在肾盂输尿管连接部梗阻手术中的应用

Retroperitoneal laparoscopy in the treatment of ureteropelvic junction obstruction

目的探讨后腹腔镜技术在肾盂输尿管连接部梗阻手术中的应用价值。方法42例肾盂输尿管连接部梗阻患者接受后腹腔镜下尿路重建手术治疗。结果42例手术均获成功。手术时间为90～260min,平均180min;术中出血量为40～120ml,平均75m1;术后住院时间为3d～12d,平均7.4d;39例获得随访,随访时间1个月～5年,平均15.3个月。所有患者临床症状消失,影像检查示肾积水减轻,连接部梗阻无复发。结论后腹腔镜技术治疗肾盂输尿管连接部梗阻,具有安全,微创,痛苦小,恢复快等优点,对于有经验的术者可替代部分开放手术。

Objective To assess the value of retroperitoneal laparoscopy in the treatment of ureteropelvic junction obstruction. Methods All 42 patients with ureteropelvic junction obstruction were received urinary reconstructive operation with laparoscopy. Results All the procedures were successful without conversion to open surgery.The operative time was 90 minutes to 260 minutes with an average of 180 minutes. The mean blood loss was 75 ml （40 ml-120 ml）. The mean postoperative hospital stay was 7.4 days （range from 3 days to 12 days）. Thirty-nine patients were followed up, the mean time was 15.3 months（range from 1 month to 5 years）. All the patients recovered with alleviation of hydronephrosis, and no recurent obstruction. Conclusion Retroperitoneal laparoscopy in the treatment of ureteropelvic junction obstruction is safe, minimally invasive,less painful, and effective. It can be a replacement for some conventional open surgeries.