经腹腔途径腹腔镜肾盂成形术的临床效果分析

The clinical effect of transperitoneal laparoscopic pyeloplasty

目的：探讨经腹腔途径腹腔镜肾盂成形术治疗肾盂输尿管连接部梗阻（ureteropelvic junction obstruction,UPJO）的手术方法及临床效果。方法：回顾分析2012年8月至2015年5月55例UPJO患者行经腹入路腹腔镜离断性肾盂成形术的临床效果。结果：手术均获成功,手术时间55-195 min,平均（73.0±11.32）min;术中出血量10-60 ml,平均（34.0±8.62）ml;术后住院6-14 d,平均（7.0±1.89）d。随访3-36个月,平均（20.0±5.79）个月,患者腰痛症状消失,肾积水改善。结论：随着腹腔镜技术的普及,腹腔镜离断性肾盂成形术成为新的标准术式,逐渐替代开放手术,而经腹腔途径肾盂成形术由于易掌握、并发症发生率低,目前被认为是治疗UPJO的重要手段,经腹腔途径腹腔镜离断性肾盂成形术是治疗UPJO安全、有效的微创方法。

Objective： To explore the operative method and clinical effect of transperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction（ UPJO）. Methods： The clinical effect of 55 patients who suffered from UPJO and underwent transperitoneal laparoscopic dismembered pyeloplasty between Aug. 2012 and May 2015 were analyzed retrospectively. Results： All processes were successful,the operative time was 55-195 min,mean operative time was（ 73. 0 ± 11. 32） min. Intraoperative blood loss was 10 to 60 ml,mean blood loss was（ 34. 0 ± 8. 62） ml. Postoperative hospital stay was 6-14 d,mean hospital stay was（ 7. 0 ±1. 89） d. Patients were followed up for 3-36 months,mean follow-up was（ 20. 0 ± 5. 79） months,the symptoms of low back pain and kidney seeper were improved. Conclusions： With the popularity of laparoscopic technique,laparoscopic dismembered pyeloplasty becomes a new standard operative procedure and gradually replaces open surgery,because it is easy to master and has low incidence of complications,it has been regarded as an important means in the treatment of UPJO. Transperitoneal laparoscopic dismembered pyeloplasty for the treatment of UPJO is an safe and effective minimally invasive method.