腹膜后腹腔镜肾盂成形术治疗肾盂输尿管连接部梗阻62例临床分析

Clinical analysis of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction:with a report of 62 cases

目的：评价腹膜后腹腔镜手术治疗肾盂输尿管连接部梗阻（ureteropelvic junction obstruction,UPJO）的手术技巧和临床效果。方法：回顾性分析施行经腹膜后腹腔镜肾盂成形术的62例肾盂输尿管连接部梗阻患者的临床资料。根据62例患者发病机理的不同,20例行腹膜后腹腔镜肾盂输尿管连接部周围压迫组织松解术,28例行Y-V成形术,14例行离断成形术。术后随访3~36个月。结果：所有患者手术均顺利完成,静脉肾盂造影（intravenous urography,IVU）提示造影剂通过良好,肾积水均明显改善。结论：腹膜后腹腔镜治疗肾盂输尿管连接部梗阻创伤小,患者术后痛苦小、康复快、住院时间短、疗效显著,可作为治疗肾盂输尿管连接部梗阻的首选方法。

Objective：To evaluate the technique and clinical effects of laparoscopic pyeloplasty. Methods：Sixty two cases with ureteropelvic junction obstruction （UPJO） undergoing retroperitoneal laparoscopic pyeloplasty were analyzed retrospectively. Aocording to the different pathogenies of these 62 cases,20 cases under went lysis. 28 cases under went Y-V ureteropelvioplasty,and 14 cases under went dismembered ureteropelvioplasty. Following-up were 3-36 months. Results： All the operations were successful. Intravenous urography （IVU） indicated that there isnt any obstruction of the anastomotic stoma and hydronephrosis were relieved in all these cases. Conclusions：Laparoscopic pyeloplasty is an effective way to treat UPJO with minimal trauma. The procedure should be considered as the first choice to treat UPJO.