腹腔镜辅助腰部小切口肾盂成形术治疗小儿肾盂输尿管连接部梗阻

Pyeloplasty using laparoscopy assisted small incision for treatment of children with ureteropelvic junction obstruction

目的:探讨腹腔镜在辅助手术治疗小儿肾盂输尿管连接部梗阻(UPJO)的疗效。方法:回顾性分析2008～2011年收治的24例UPJO患儿的临床资料。24例患儿均采用腹腔镜辅助腰部小切口离断式肾盂成形术。其中肾盂输尿管连接部狭窄18例,肾盂输尿管高位连接1例,迷走血管压迫3例,输尿管息肉2例。结果:24例手术顺利完成,手术切口长2.5～4.5cm,平均3.0cm,术后梗阻症状解除。1例患儿术后出现吻合口漏,术后延长切口引流管留置时间后愈合。术后随访6～36个月,复查B超及IVU显示患肾形态基本正常。结论:腹腔镜辅助小切口离断式肾盂成形术治疗小儿肾盂输尿管连接处梗阻创伤小,手术简便快捷、疗效可靠。

Objective;To explore the efficacy of laparoscopy assisted small incision for treatment of childrenwith ureteropelvic junotion ohstrue,ion （UPJO）. Methodt：Clinical data of 24 cases of UPJO treated in our hospital from 2008 to 2011 were retrospectively analyzed. All 24 cases underwent pyeloplasty with laparoseopic-assisted small incision,： ine!uding 18 with junction obstruction, 1 with ureteropelvic high connectivity, 3 with aberrant vas- cular Compression, and 2 with ureteral polyps. Result：Twenty-four cases surgeries are successful and obstructive symptoms were relieved. Incision lengths are from 2.5 cm to 4.5 cm, in average 3.0 cm. One of children with postoperative anast0motic leakage was cured by extend the indwelling time of drainage tube. After 6-36 months follow up, ultrasonograpby and IVU showed renal morphology approach to normal. Conelaslon：Laparoscopy-assis- ted small incision pyeloplasty for children with UPJO is minimally invaslve, simple and efficient, effective and reli-able.