开放性与后腹腔镜手术治疗下腔静脉后输尿管疗效分析

Efficacy Analysis of Open and Retroperitoneal Laparoscopic Surgical Treatment of Circumcaval Ureter

目的:分析开放与后腹腔镜手术治疗下腔静脉后输尿管的疗效。方法:本组11例中开放手术4例,应用传统的输尿管切断复位矫形术。腹腔镜手术7例,采用后腹腔径路,三个穿刺通道做输尿管切断、复位,移至下腔静脉前方,做端端吻合术。术后定期随访。结果:开放手术4例成功,无并发症。手术平均时间60min,术中平均出血量216m1。平均住院时间14.6d,术后平均康复时间51d。后腹腔镜手术7例均成功,无中转手术及并发症。平均手术时间110min,术中平均出血量45ml。平均住院时间7.1d,术后平均康复时间21.5d。结论:后腹腔镜手术治疗下腔静脉后输尿管疗效可靠,安全,较开放手术创伤小,康复快。

Objective： To evaluate the effectiveness of open and retroperitoneal laparoscopic surgical treatment of circumcaval ureter. Methods：Among 11 cases with circumcaval ureter,4 were treated by open surgical therapy in which traditional orthopedic surgery following the ureter cut off was performed. Seven cases were treated with retroperitoneal laparoscopic surgery.The operative process was operated in a laparoscopic transretroperitoneal approach. After exposing the inferior vena eava and ureter, the retrocaval ureteric segment was safely incised. The ureter was then transpositioned to a mormal anatomic position followed by laparoscopic intracorporeal uretero and ureteric anastomosis. All cases have been successfully followed up.Results：The open operation involved 4 eases were successfully performed and no post-operative complication occurred. The mean operation time was 60min and the blood loss was 210ml in the operation. The mean hospitalization time was 14.6days and the recovery time was 5 t days. The retroperitoneal laparoscopic surgery with 7 cases were successful. There was no complication or transfering surgery during the operation. The mean operation time was 95min and blood loss was 45ml during the operation. The mean hospitalization time was 7.1days and recovery time was 21.5days.Conclusions：The retroperitoneal laparoscopic surgical treatment is as effective as open operation. However, it is feasible and technically safe with less trauma and quick recovery.