后腹腔镜下腔静脉后输尿管扩张段离断矫正术病例报道并文献复习

Retroperitoneal laparoscopic expanded dismembered ureteroplasty of a retrocaval ureter:case report and review of the literature

目的报道后腹腔镜途径治疗下腔静脉后输尿管离断矫正术的初步经验。方法患者21岁,男,无任何不适,体检超声检查发现右肾轻度积液、右输尿管上段扩张,静脉肾盂造影(IVU)、逆行插管肾盂造影提示腔静脉后输尿管。患者取左侧卧位,建立后腹膜间隙,常规于肋弓下置三个鞘卡,离断扩张处输尿管后端端无张力吻合。结果手术经后腹腔镜完成,用时170min,出血20ml,术中及术后无并发症发生。结论后腹腔镜下于扩张处离断输尿管矫正术可以作为下腔静脉后输尿管首选治疗方案。

Objectives To report our techniques and experience with retroperitoneal laparoscopic ureteroplasty for retrocaval ureter. Methods A 21-year-old male presented with absence of symptoms. Right hydronephrosis with dilated upper ureter was evident on physical examination. The patient was placed in a left lateral deeubitus position, who underwent retropefitoneal laparoseopie expanded dismembered ureteroplasty. A 3-port, balloon-dissecting, retroperitoneal approach was used. Results The operations were completed laparoscopically, and no open conversions was required. The operating time was 170 min- utes. The blood loss was 20 ml. No intraoperative and post operative complications occurred. Conclusions Retroperitoneal laparoscopic approach should be considered to he first-line treatment for this congenital anomaly.