后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部狭窄18例

Effect of dismembered pyeloplasty assisted by retroperitoneal laparoscopy on 18 cases of uretero- pelvic junction obstruction

目的评价后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部狭窄（UPJO）的-临床效果。方法采用腹膜外路径对18例uPJO患者行离断式肾盂输尿管成形术。打开肾周筋膜，以肾下极为标志游离出肾盂输尿管连接部，切除狭窄部分，端端吻合肾孟输尿管并留置双J管。结果18例患者手术全部成功，手术时间90～160min，平均120rain；术中出血量50-110m1，平均80ml；无严重并发症发生。术后住院7～12d，平均8d。18例随访3～24个月，平均10个月；超声示肾积水均不同程度好转，16例静脉肾盂造影无吻合口狭窄。结论后腹腔镜下离断式肾孟输尿管成形术治疗UPJO有效、可行，可望成为肾盂输尿管连接部狭窄首选治疗方法。

Objective To evaluate the clinical efficacy of dismembered pyeloplasty assisted by retroperitoneal laparoscopy on ureteropelvic junction obstruction （UPJO）. Methods A total of 18 pa- tients with UPJO underwent dismembered pyeloplasty. During the operation, the fascia renalis was opened and the reteropelvic junction obstruction was dissociated and dissected. The end-to-end anasto- mosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter. Re- suits All the operations were performed successfully. The operation time was 90 - 160 min （ mean120 rain）, the blood loss was 50 - 110 ml （ mean 80 ml ） , and the postoperativehospitalization time 7 - 12 d （ mean 8 d）. No with intravenous urography for 3 - 24 months （ stricture. Conclusions Dismebered pyeloplasty little injury, effective and safe, and can become struction. severe complications occurred. Follow-up assessment mean 10 months） in 16 patients showed no ureteral assisted by retroperitoneal laparoscopy is a method with the first treatment method of ureteropelvic junction obstruction.