腹腔镜辅助经腹路径双侧肾盂成形术的临床应用

Transperitoneal laparoscopy-assisted dismembered pyeloplasty in children with bilateral ureteropeivic junction obstruction

目的探讨腹腔镜辅助经腹路径。肾盂成形术在儿童双侧肾盂输尿管连接部梗阻中的应用。方法2007年2月至2011年1月，收治12例双侧肾盂输尿管连接部梗阻肾积水患儿，男8例，女4例；年龄2～10岁，平均年龄4．9岁；12例均采用腹腔镜辅助经腹路径肾盂成形术。结果12例手术成功11例，中转开放手术1例。手术时间120-170min，平均140min；术中出血20~50ml，平均25ml。无严重围手术期并发症发生。全部获得随访，术后B超随访肾积水明显改善。结论腹腔镜辅助经腹路径肾盂成形术治疗双肾盂输尿管连接部梗阻创伤小，安全，有效，有很好的应用前景。

Objective To study the application of transperitoneal laparoscopy-assisted dismem- bered pyeloplasty in children with bilateral ureteropelvic junction obstruction （UPJO）. Methods From Feb,2007 to Jan 2011, a total of 12 children with bilateral UPJO underwent transperitoneal laparosco- py-assisted dismembered pyeloplasty. Among them, there were 8 boys and 4 girls. The ages ranged from 2 to 10years（mean,4. 9 years）. Results Eleven operations were completed successfully, 1 case was converted to open surgery. The operation time was 120~170 min （mean： 140 min） ; The estimated intraoperative blood loss was 20~50ml （mean：25 ml）. No serious perioperative complication occurred. The twelve cases wet followed up,Ultrasound examinations after the procedure showed the hydrone- phrosis was improved. Conclusions The application of transperitoneal laparoscopy-assisted dismem- bered pyeloplasty with bilateral UPJO is a minimally invasive,safe and effective procedure for treating bilateral UPJO.