双通道曲卡在肾盂、输尿管疾病后腹腔镜术中的应用

The application of homemade double-channel trocar in retorpeirtoneal laparoscopy of renal pelvis and ureter diseases

目的总结利用双通道曲卡放置双J管在肾盂、输尿管疾病后腹腔镜术中应用的体会。方法回顾性分析苏州大学附属第二医院泌尿外科2007年05月至2014年06月住院的因肾盂输尿管疾病行上尿路后腹腔镜手术的666例患者的临床资料,其中行肾盂切开取石术50例、输尿管切开取石术520例、肾盂-输尿管成形术92例和腔静脉后输尿管矫形术4例,术中均应用双通道曲卡放置双J管。结果 666例手术均获成功,手术时间45~260 min,平均（112±29）min。术中通过双通道曲卡放置双J管,操作时间在1~8 min,平均（2±1）min,所有患者术中、术后均未输血。术后恢复顺利,术后住院4~9 d,平均（6±1）d。术后行超声或X线检查提示双J管均位置良好,4~8周后拔除患侧输尿管内双J管。结论肾盂、输尿管疾病后腹腔镜手术中通过双通道曲卡放置双J管安全、简便、快捷,效果确切,值得在临床上推广应用。

Objective To Summarize our initial experiencs of the double-channel trocar in retorpeirtoneal laparoscopy for the renal pelvis and ureter diseases. Methods The clinical data of a total of666 patients with renal pelvis or ureter diseases who were performed retorpeirtoneal laparoscopic pyelolithotomy or retorpeirtoneal laparoscopic ureterolithotomy and retorpeirtoneal laparoscopic pyeloureteroplasty in the Second Affiliated Hospital of Soochow University between May 2007 to June 2014 were analyzed retrospectively. Among these patients, pyelolithotomy implemented in 50 cases,ureterolithotomy was performed in 520 cases, the pyeloureteroplasty in 92 cases and ureteroplasty in retrocaval ureter in 4 cases. For these operations, to apply the double-channel trocar to lay aside the double J tube. Results The procedures were all successful in 666 cases. The operative time was 45~260 min with a mean of（112 ±29） min. It was easy and quick to lay aside the double J tube through the double channel trocar. We could complete in 1~8 minutes with a mean of（2 ±1） min. No transfusion was needed. Patients recovered quickly. The postoperative hospital stay was 4~9 days with a mean of（6 ±1） days. The double J tubes were removed 4~8 weeks after operation. Conclusion To lay aside the double J tube is easy, quick and safe through the double-channel torcar during the retorpeirtoneal laparoscopy for the renal pelvis and ureter disease. It is worth promoting the application in clinical.