经腹腔路径腹腔镜输尿管膀胱角悬提吻合术治疗输尿管中下段长段狭窄的疗效

Efficacy of laparoscopic bladdeconstr horn technique in the treatment of long-distance lower ureteral stenosis

目的探讨经腹腔路径腹腔镜输尿管膀胱角悬提吻合术治疗输尿管中下段长段狭窄的疗效。方法回顾性分析我科2008年9月至2013年5月收治的10例输尿管中下段长段狭窄患者的临床资料,其中男6例,女4例,14-65岁,平均40岁,狭窄段均位于输尿管中下段,狭窄段长度4-6 cm,平均长度5 cm,10例患者均行腹腔镜输尿管膀胱角悬提吻合术,术后输尿管内留置双J管2-3个月。结果 10例手术均获得成功。手术时间120-180 min,平均126 min;术中出血30-150 mL,平均64 mL;术后住院时间7-14 d,平均9.4 d;术后2-3个月行膀胱镜检查,拔除输尿管内双J管,术后6个月及12个月复查CT、泌尿系B超提示输尿管通畅,肾积水较术前明显改善。结论腹腔镜下输尿管膀胱角悬提吻合术治疗输尿管中下段长段狭窄效果确切,具有创伤小、恢复快、住院时间短等优点,是一种有效的微创治疗方法。

Objective To explore the efficacy of laparoscopic bladdeconstr horn technique in the treatment of long-distance lower ureteral stenosis. Methods Data of 10 patients with long-distance lower ureteral stenosis treated in our center during Sept. 2008 to May 2013 with laparoscopic bladdeconstr horn technique were retrospectively analyzed. The patients included 6 males and 4 females,aged 14-65 years（ average 40 years）. The length of stenosis segment was 4-6 cm（ average 5 cm）. All patients underwent laparoscopic bladdeconstr horn technique operation and D-J tube was indwelt for 2-3 months after the operation. Results All operations were successful. Operation time was 120-180 min,average126 min; bleeding volume 30-150 mL,average 64 mL; postoperative hospital stay 7-14 days,average 9. 4 days. The D-J tube was removed after 2-3 months. CT and urinary tract ultrasonography were performed 6 and 12 months after the operation. The results showed that the patients＇ hydronephrosis was remarkably reduced. Conclusion Laparoscopic bladdeconstr horn technique is an effective minimal method to treat long-distance lower ureteral stenosis with advantages of small trauma,quick recovery and short hospital stay.