经腹腔途径腹腔镜治疗重复肾输尿管畸形

Laparoscopic transperitoneal heminephroureterectomy for the treatment of duplex kidney anomalies

目的探讨经腹腔途径腹腔镜行半肾输尿管切除术治疗重复肾输尿管畸形的手术方法和临床效果。方法 2007年1月～2009年3月采用经腹腔途径腹腔镜半肾输尿管切除术治疗重复肾输尿管畸形患者15例。男4例,女11例,其中小儿9例,成人6例;年龄4个月～56岁,平均22.6岁。左侧9例,右侧6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 15例手术均获成功。手术时间41～105min,平均62min,术中出血量5～90mL,平均35mL。术后住院3～9d,平均5.6d。术中和术后均未出现明显并发症。随访1～26个月,平均15.4个月,下半肾功能良好。结论经腹腔途径腹腔镜半肾输尿管切除术治疗重复肾输尿管畸形具有创伤小、出血少、术后恢复快等特点。

[Objective]To evaluate the technical feasibility and clinical efficacy of laparoscopic transperitoneal heminephroureterectomy in the duplex kidney anomalies.[Methods]Laparoscopic transperitoneal heminephroureterectomy was performed on 15 patients （male and female） with a mean age of 22.6 years （4 months～56 years）. Of the procedures, 6 cases were on the right side and 9 on the left. The operating time, blood loss, intraoperative and postoperative complications and the operative efficacy were observed. [Results]All laparoscopic operations were performed successfully without conversion to open surgery and with a mean operative time of 62 （41～105） min. Blood loss was mini-mal and no intraoperative complications occurred. The average length of hospital stay was 5.6 （3～9） days. All patients were followed up and the low pole kidney was well. [Conclusion]These data demonstrate that laparoscopic heminephroureterectomy is feasible , with mini-invasion, less blood loss, a better cosmetic result and a shorter hospital stay compared to open surgery with duplex kidney.