小儿腹腔镜气膀胱Cohen输尿管移植术

Pneumocystoscopic Cohen ureteric reimplantation in children

目的总结小儿腹腔镜气膀胱Cohen输尿管移植术的治疗效果和手术经验。方法对2006—04—2008．10期间14例输尿管末端畸形疾病患儿进行腹腔镜气膀胱Cohen输尿管移植术，年龄6个月-12岁，8例原发性膀胱输尿管返流，5例输尿管末端狭窄，1例输尿管开口囊肿，并与同期42例开放手术在平均手术年龄、手术时间、失血量、住院时间、并发症和远期效果进行比较。结果14例腹腔镜气膀胱Cohen输尿管移植术手术均获得成功，平均手术年龄（5．1±4．2）岁，平均手术时间（128．9±52．1）min，与开放手术组相当（P〉0．05），平均手术失血量（4．7±1．3）ml，小于开放手术组（P〈0．05），平均术后住院时间（6．9±2．4）d，小于开放手术组（P〈0．05），所有病例无术后并发症，远期随访输尿管排泄通畅，无返流，与开放手术组一致（P〉0．05）。结论小儿腹腔镜气膀胱Cohen输尿管移植术安全、有效，是一个治疗小儿输尿管末端畸形的良好微创手术方式。

Objective To summarize the therapeutic efficacy and experience of pneumocystoscopic Cohen ureterie reimplantation in children. Methods During April 2006 to October 2008, 14 children with monstrositas in the distal ureter were treated with pneumocystoseopic Cohen ureteric reimplantation. In these cases, age ranged from 6 months to 12 years, 8 cases suffered from vesicoureteral reflux, 5 cases with vesicoureteral junction obstruction and 1 ease with ureterocele. The eomparision between the group of eases used pneumocystoseopie Cohen ureterie reimplantation and the group of 42 cases used open Cohen＇ s procedure included age, blood loss, post-operation hospital stay, complication and therapeutic efficacy. Results All procedures were accomplished without conversion. The mean operative age was （5.1 ± 4. 2 ） years and the duration of operation was （128. 9± 52. 1 ） minutes which were coincidence to the open procedure （ P 〉 0. 05 ） ; blood loss was （4. 7 ± 1.3 ） ml, lower than open procedure （ P 〈 0. 05 ） , the postoperation hospital stay was （6. 9 ± 2.4） days, lower than open procedure. All the eases had no complication, none of them had obstruetion of ureter and vesieoureteral reflux in the 0. 5 - 1 year follow-up period, which were eoineideneed to the open procedure （ P 〉 0.05 ）. Conclusion Pneumocystoscopic Cohen ureteric reimplantation as a well minimally invasive surgery, which is safe and reliable in children with monstrositas in the distal ureter.