腹腔镜肾盂成形术治疗输尿管连接处梗阻疗效观察

Laparoscopic Ureteropelvic Junction Obstruction Pyeloplasty

目的:评价腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻(UPJO)的临床疗效及其可行性。方法:对50例UPJO均有不同程度肾盂积水患者分别使用Anderson-Hynes、Foley Y-V成形术、Fenger成形术及Hellst rom成形术进行治疗。结果:50例手术均获成功,无一例中转开放手术。手术时间2.5～4.5 h,出血量35～88 ml。40例术后随访6～24个月,IVP检查UPJ吻合口未见狭窄,肾盂输尿管排尿功能好,手术侧肾盂积水明显减轻或基本消失。结论:腹腔镜肾盂成形术具有术中创伤小、术后恢复快、疼痛减轻的优点,效果优于开放手术,是既安全又有效的微创手术方法。

Objective：To elucidate the clinical curative effect s and feasibilities of the management of ureteropelvic junction obstruction by transabdominal laparoscopic pyeloplasty. Methods：The clinical data of 50 cases of patient s with UPJO were collected from 2001 to 2009. 50 cases with ureteropelvic junction （UPJ） obstruction underwent by transabdominal laparoscopic pyeloplasty. As laparoscopic pyeloplasties , Foley Y-V pyeloplasty , Fenger pyeloplasty and Hellst r？ m techniques were resorted base on the judgement s and flit rations during the operations. Results： All the operations have been successfuL. There was no conversion to open surgery, the operating time being 2.5 to 4.5 h and the blood loss 35 to 88 ml. Ultrasound B investigation 3 months after the procedure showed no hydronephrosis in all and IVP analysis in 40 cases 6 to 24 months after the operation disclosed good outcome with less morbidity. Conclusions： As compared to open pyeloplasty , laparoscopic pyeloplasty has the advantages of rapid recovery , less pain , mini invasion and less blood loss. It was a safe, and effective way to treat UPJ obstruction with minimal trauma to the patient.