后腹腔镜手术治疗成人重复肾输尿管畸形

Retroperitoneal laparoscopic heminephroureterectomy in treatment of duplex kidney and ureter deformity

目的:探讨后腹腔镜手术治疗成人重复肾输尿管畸形的临床经验及手术疗效。方法:回顾分析2006年11月至2011年9月为18例成人重复肾输尿管畸形患者行后腹腔镜手术的临床资料,其中男6例,女12例,平均(30.2±7.8)岁。18例重复肾均位于肾上极,其中左侧13例,右侧5例。结果:18例手术均顺利完成,无一例中转开放手术,围手术期无严重并发症发生。手术时间平均(103±24.5)min,术中出血量平均(45.3±21.6)ml,术中肾静脉损伤1例,术后发生尿漏1例,术后平均住院(5.5±1.7)d。平均随访(41.3±15.5)个月,患者术前原有症状消失,肾功能正常,术后3个月复查CTU或MRU检查,未见重复肾。结论:后腹腔镜重复肾输尿管切除术安全、有效,具有患者创伤小、康复快的优点,可作为治疗成人重复肾输尿管畸形的首选方法。

Objective：To study the clinical experiences and effects of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney and ureter.Methods：The clinical data of 18 patients（6 males and 12 females） with duplex kidney and ureter who underwent retroperitoneal laparoscopic heminephroureterectomy from Nov.2006 to Sep.2011 were analyzed retrospectively.Mean age was（30.2±7.8）years.All the duplex kidney located on the upper pole,with 13 cases on the left side and 5 cases on the right side.Results：All the 18 cases were operated successfully with neither conversion to open surgery nor severe perioperative complications.The mean operation time was（103±24.5） min,and mean blood loss was（45.3±21.6） ml.1 case suffered intraoperative renal vein injury,and another patient suffered postoperative urinary leakage.The mean postoperative hospital stay was（5.5±1.7） d.In a mean follow up for（41.3±15.5） months,the patients＇ preoperative symptoms disappeared after surgery with normal renal function.No duplex kidney was detected under CTU or MRU scan 3 months after surgery.Conclusions：Retroperitoneal laparoscopic heminephroureterectomy is safe and effective with the advantages of less trauma and faster recovery,it can be the first choice to treat the adult patients with duplex kidney and ureter deformity.