腹部小切口手术治疗小儿肾盂输尿管连接部梗阻

Dismembered pyeloplasty combined with minor abdominal incision in treatment of ureter pelvic Junction Obstruction in Children

目的探讨腹部小切口离断式肾盂成形术治疗小儿肾盂输尿管连接部梗阻的临床疗效。方法2010年12月至2011年12月作者采用腹部小切口腹膜外入路行离断式肾盂成形术，治疗小儿肾盂输尿管连接部梗阻患儿33例，分析其手术入路、临床效果及并发症情况。结果33例均手术成功，平均手术时间（89±37）min，平均出血量（16±12）mL，伤口愈合良好。术后随访3~12个月，无吻合口狭窄、尿瘘、泌尿系感染等并发症，患儿肾盂均不同程度缩小，肾实质增厚。结论腹部小切口离断式肾盂成形术治疗小儿肾盂输尿管连接部梗阻，操作简单，损伤少，并发症少，疗效好，值得临床推广。 Abstract：

Objective To assess the feasibility and effect of minor abdominal incision in dismembered Anderson-Hynes pyeloplasty in the treatment of ureter pelvic junction obstruction （UPJO） in children. Methods Retrospective analysis was carried out in 33 children with UPJO treated by minor abdominal incision in dismembered Anderson-Hynes pyeloplasty between Dec. 2010 and Dec. 2011. Data including the volume of the blood loss, the operating time, the postoperative convalescence, the operation complication and the long-term outcome were collected and reviewed retrospectively. Results Operations were all successful in 33 children. The mean operation time was（ 89 ±37）min, the mean blood loss was（ 16 ±12 ）mL, and the wound healed well. No perioperative complication was observed. All the patients were followed up from 3 m to 12 m, no obstruction of the anastomotic stoma was found, but hydronephrosis was remitted and renal functions were improved. Conclusions Minor abdominal incision in dismembered Anderson-Hynes pyeloplasty is an effective and safe way to treat UPJO in children.