双镜联合一期治疗重复肾盂输尿管连接部梗阻合并多发肾结石一例

One-stage combination therapy and literature review of laparoscope surgery to perform nephrorrhaphy and ureteroscopic lithotripsy surgery to treat repeated ureteropelvic junction obstruction

目的探讨联合腹腔镜及输尿管软镜一期行重复肾盂成形+输尿管软镜取石术治疗重复肾盂输尿管连接部梗阻(ureteropelvic junction obstruction, UPJO)合并肾结石的临床疗效。方法结合1例右侧重复肾盂UPJO合并下肾结石病人的临床资料,给予一期联合手术治疗,术中放置1根F6双J管上端置入下肾盂。结果顺利完成手术,术中无大出血、周围脏器损伤等并发症。手术时间约155分钟,软镜取石时间约65分钟,出血约50 ml,软镜完整检视重复肾盂,无盲区,术后复查腹部平片,取石率100%。拔除双J管后复查重复肾脏积水程度明显缩小。结论一期腹腔镜下重复肾盂成形术联合输尿管软镜手术安全、有效,可作为重复肾盂UPJO合并结石的一种理想治疗方式。

Objective To investigate the clinical effect of one-stage combination therapy laparoscope surgery to perform nephrorrhaphy and ureteroscopic lithotripsy surgery to treat repeated ureteropelvic junction obstruction(UPJO) with renal calculus.Method The surgical procedure including one double "J" ureteral catheter type F6 placed into renal pelvis was performed on one case of UPJO combined with renal calculus.Result The surgery was successfully completed without serious complications, such as heavy bleeding and peripheral organ damage.The whole operation lasted 155 minutes including about 65 minutes of removal of renal calculus.There was about 50 ml of bleeding during the procedure.A complete inspection by flexible ureteroscope on repeated renal pelvis showed no blind spots.After the surgery, reviewed KUB showed the removal rate of renal calculus was 100%.After removing the double "J" tube, the examination of the repeated renal showed significantly reduced hydronephrosis.Conclusion One-stage combination therapy of laparoscope surgery to perform nephrorrhaphy and ureteroscopic lithotripsy is safe and efficacy, it can be adopted as an ideal therapy to treat the case of UPJO combined with renal calculus.