后腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻

Retroperitoneal laparoscopic dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction

目的:评价后腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻(ureteropelvic junction obstruction,UPJO)技术要点及临床疗效。方法:通过后腹腔途径在腹腔镜下对30例UPJO患者行离断式肾盂成形术,其中男18例,女12例,年龄在16～48岁;异常血管压迫4例,合并泌尿系感染8例。结果:30例手术均获成功,无一例中转开放手术。手术时间120～235min,平均105min;出血量85～135ml,平均115ml。30例术后随访6～24个月,经B超、IVU检查,肾盂输尿管吻合口未见明显狭窄,患肾积水明显减轻或消失,临床症状消失。结论:后腹腔镜肾盂成形术是一种创伤小、安全可靠、疗效确切的微创手术方法。

Objective：To investigate the clinical effects of retroperitoneal laparoscopic pyeloplasty for uretero- pelvic junction （UPJ）obstruction,and review the technical deypoints. Method：The clinical data of 30 patients with UPJ obstruction who underwent retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty were ret- rospectively analyzed. There were 18 males and 12 females,their age ranged from 16 to 48 years. Four cases were compression from crossing vessels and 8 cases were complicated with urinary tract infection. Result： Retroperitoneal pyeloplasty was performed successfully in all 30 cases. The operative time ranged from 120 to 235 min （mean 105 min）. The estimated blood lost ranged from 85 to 135 ml （mean 115 ml）. During the follow up of 6 to 12 months, B-ultrasound and IVU showed the hydronephrosis relieved obviously in all patients, and no anastomotic stoma stricture of UPJ developed. At the same time, the clinical symptoms disappeared among these cases. Conclusion： Retroperitoneal laparoscopic dismembered pyeloplasty is a minimally invasive surgical method, which has the ad vantages of high efficiency, reliability, safety, mini- invasion and rapid recovery.