腹腔镜治疗儿童重复肾输尿管畸形(附8例报告)

Laparoscopic Heminephroureterectomy for the Treatment of the Abnormalities Duplex Kidney and Ureter in Children

目的:探讨腹腔镜上半肾输尿管切除术治疗儿童重复肾输尿管畸形的手术方法和临床效果。方法:2007年1月～2008年10月采用经腹腔路径腹腔镜半肾输尿管切除术治疗儿童重复肾患者8例,其中男3例,女5例,平均年龄38.6个月,左侧3例,右侧5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:8例手术均成功。手术时间73～110min,平均92min,术中出血量5～40ml,平均22ml。术后住院3～6天,平均4.8天。术中和术后均未出现明显并发症。随访1～12个月,平均6.4个月,下半肾功能良好。结论:腹腔镜半肾输尿管切除术治疗儿童重复肾具有创伤小、出血少、恢复快等特点。

Objective.. To evaluate the technical feasibility and clinical efficacy of laparoscopic heminephroureterectomy in the children with abnormalities duplex kidney and ureter. Methods：Laparoseopic heminephroureterectomy was performed in 5 girls and 3 boys with the mean age of 38.6 （4-84） months from January 2007-October 2008. Of the procedures, 5 eases were on the right side and 3 on the left. The operating time, blood loss, intraoperative and postoperative complications and the operative efficacy were observed. Resulls： All laparoscopic operations were performed successfully without conversion to open surgery with the operative time from 73-110 min （mean 92 min）. Bleeding volume was from 5 40 ml （mean 22 ml）. The length of hospital stay was from 3-6 days （mean 4.8 days）. No intraoperative and postoperative complications occurred. The follow-up was from 1-12 months （ mean 4 months）. The low pole kidney was well. Conclusions： Laparoscopic heminephroureterectomy is feasible and associated with mini-invasion, less blood loss, a better cosmetic result and a shorter hospital stay compared to open surgery for abnormalities duplex kidney and ureter.