单纯经脐腹腔镜手术切除发育不良肾

Transumbilical laparoscopy for renal dysplasia

目的：评价单纯经脐腹腔镜手术切除发育不良肾的可行性及效果。方法自2009年10月至2014年1月我们共对26例单侧肾发育不良患儿行经脐腹腔镜发育不良肾切除术。回顾性分析26例患儿临床资料，总结治疗经验。结果26例患儿中，男性9例，女性17例。年龄1．2～7岁，平均年龄3．6岁。14例因输尿管开口异位导致小便失禁就诊，5例因反复泌尿系感染就诊，1例因高血压就诊，6例为体检发现。入院后经 B 超、增强 CT 及输尿管逆行造影等诊断为单侧肾发育不良。患儿均采用经脐腹腔镜手术切除发育不良肾。手术时间（82＆#177;39）min。其中15例发育不良肾位于下腹部或盆腔，11例发育不良肾位于原位。术后无腹腔出血、伤口感染等并发症。手术后随访6个月，患儿初始症状均消失。脐部伤口隐蔽不易发现。结论单纯经脐腹腔镜手术切除发育不良肾安全可行，与普通多孔腹腔镜手术相比，具有疤痕更隐蔽的优点。

Purpose To evaluate the feasibility of transumbilical laparoscopy for resecting renal dyspla-sia. Methods A series of 26 patients underwent transumbilical laparoscopy during October 2009 to January 2013.Their clinical data were retrospectively reviewed. Results There were 9 boys and 17 girls with a mean age of 3.6 （1.2- 7）years.The etiologies were urinary incontinence due to ectopic ureterostoma （n =14）,re-current urinary infection （n =5）,hypertension （n =1）and renal dysplasia during health examination （n =6）. All children were diagnosed by urograph,enhanced CT and retrograde ureteral visualization.The mean operative duration was 82 ＆#177;39 min.Renal dysplasia was found in pelvic cavity or lower abdomen （n =15）and in situ （n=11）.There was no such complication as hemorrhage or wound infection.The follow-up period was over 6 months.All original symptoms disappeared and wound scars became hidden in umbilicus. Conclusions Tran-sumbilical laparoscopy is both safe and feasible for renal dysplasia.And it leaves no obvious abdominal scar.