摘要
目的:探讨小切口Anderson-Hynes术治疗小儿肾盂输尿管连接部梗阻(UPJO)的疗效。方法:回顾性分析我院近5年来收治的34例UPJO患儿的临床资料。均采用小切口Anderson-Hynes术治疗。采用经患侧腰部横切口,长约2.5～3cm,逐层暴露肾脏。于肾下级找到扩张的肾盂,吸净肾盂内积液,将肾盂、输尿管提至切口外,于正常输尿管起始部背侧及欲切除的扩张肾盂上、下两极分别预置标志线,斜形切除病变输尿管及多余肾盂组织,纵形裁剪输尿管腹侧。使之成一斜面,肾盂输尿管内留置6～8F输尿管支架管,用6～0无损伤可吸收线行肾盂术输尿管吻合。缝闭肾盂后将肾盂、输尿管送回切口内。输尿管支架管引至腹壁外固定,逐层缝合切口。结果:手术时间明显缩短,全部病例梗阻症状解除。1例合并吻合口瘘,经延迟拔切口皮管后逐渐愈合。术后随访3个月至2年,全部病例肾形态基本正常。结论:小切口Anderson-Hynes术治疗小儿肾盂输尿管连接部梗阻。术式简单,创伤小,恢复快。
Objective：To investigate the Anderson-Hynes small incision surgery pediatric ureteropelvic junction obstruction（UPJO） effect.Methods：Retrospective analysis of 5 years in our hospital 34 patients were treated UPJO children with clinical data.Were Anderson-Hynes small incision surgery.Adopted by the ipsilateral lumbar transverse incision,about 2.5-3 cm,layer by layer exposed kidney.Expansion in the renal pelvis found at lower levels,net absorption fluid within the pelvis,the renal pelvis,ureter raised to the incision,at the beginning part of the normal ureter expansion of the dorsal and pelvic want to remove the upper and lower poles were pre-identification line,oblique ureter and renal pelvis lesions removed excess tissue,the ventral longitudinal cut ureter.Make it into a ramp ureteropelvic 6-8F indwelling ureteral stent,with 6-0 absorbable suture line without damage pelvis ureteral anastomosis.Joints will be closed pelvis renal pelvis,ureter back incision.Ureteral stent fixation lead to the abdominal wall,sutured incision.Results：The operative time was significantly shortened,obstruction symptom relief in all cases.1 with anastomotic leakage,the delay in pulling the skin tube incision healed.Were followed up for 3 months to 2 years,all patients with normal renal morphology.Conclusion：Anderson-Hynes small incision in the treatment of ureteropelvic junction obstruction in children.Simple surgical trauma and faster recovery.
