腹腔镜治疗儿童异位肾伴其他泌尿系统畸形9例

Laparoscopic treatment of ectopic kidney with other urinary malformations in 9 children

目的:探讨儿童异位肾伴其他泌尿系统畸形的临床特点与治疗方法,评估腹腔镜手术的安全性及有效性。方法:回顾性分析重庆医科大学附属儿童医院泌尿外科2009年10月至2018年7月收治异位肾伴其他泌尿系统畸形并行腹腔镜手术治疗9例患儿的临床资料。结果:儿童异位肾常合并其他泌尿系统畸形:同侧肾发育不良(6/9)、同侧肾盂输尿管连接处狭窄(3/9)、同侧输尿管开口异位(5/9)、尿道阴道瘘(2/9),6例行腹腔镜下发育不良肾及输尿管切除术,3例行腹腔镜下离断式肾盂成形术,手术顺利,无中转开腹病例,所有病例术前症状均有改善,随访肾积水无复发。结论:异位肾常伴其他泌尿系统畸形,采用腹腔镜技术治疗创伤小、安全、效果好。

Objective:To investigate the clinical features and treatment of ectopic kidney with other urinary malformations in children,and to assess the safety and effectiveness of laparoscopic treatment.Methods:The clinical data of 9 children with ectopic kidney and other urinary malformations treated with laparoscopy from October 2009 to July 2018 in Department of Urology,Children’s Hospital of Chongqing Medical University were retrospectively analyzed.Results:Ectopic kidney often occurred with other urinary malformations in children,including ipsilateral renal dysplasia(6/9),ipsilateral ureteropelvic junction stenosis(3/9),ipsilateral ectopic ureteral orifice(5/9),and urethrovaginal fistula(2/9).Six children underwent heminephrectomy and nephroureterectomy and 3 children underwent dismembered pyeloplasty by laparoscopy.The operations were successful without conversion to open surgery.All children showed a postoperative improvement in preoperative symptoms and follow-up showed no recurrence of hydronephrosis.Conclusion:Ectopic kidney often occurs with other urinary malformations in children and it is minimally invasive,safe,and effective to treat this disease with laparoscopy.