机器人辅助腹腔镜系统在肾盂输尿管连接处狭窄中的临床应用

Clinicalapplication of robot-assisted laparoscopy in ureteropelvic junction obstruction

目的:探讨机器人辅助腹腔镜系统在肾盂输尿管连接处狭窄治疗中的应用价值。方法:收集2014年10月至2019年12月我院行机器人辅助腹腔镜手术治疗的99例肾盂输尿管连接处狭窄患者的临床资料,男74例,女25例,平均年龄(28±15)岁。左侧、右侧和双侧肾盂输尿管连接处狭窄分别为54例、40例和5例。手术中同时处理合并疾病共16例,其中同侧尿路结石13例。结果:99位患者均接受机器人辅助肾盂输尿管离断成形术,合并疾病同期处理。手术时间为(179±58)min。术后拔除引流管、导尿管时间分别为(5.2±2.0)d和(7.5±2.7)d,术中未发生并发症,无中转开放手术。Clavien-Dindo分类(Ⅰ~Ⅱ级)13例(13.1%)。平均住院日(14±4) d。术后平均住院日(7.0±2.2)d。随访(11.9±0.4)个月,均无复发。结论:机器人辅助腹腔镜手术治疗肾盂输尿管连接处狭窄具有创伤小,手术视野清晰,恢复快,手术成功率高,并发症少等优点。它也可以同时处理合并疾病,在临床应用中具有明显的优势。

Objective To explore the value of robot-assisted laparoscopy in the treatment of ureteropelvic junction obstruction(UPJO).MethodsMedical records were collected from 99 patients who underwent robot-assisted ureteropelvic dissociation plasty in our hospital from October 2014 to December 2019,including 74 males and 25 females,with an average age of(28±15)years.There were 54 cases with left side UPJO,40 cases right side and 5 cases bilateral side.16 cases were treated with concurrent diseases during operation,including 13 cases with ipsilateral urolithiasis.ResultsAll the 99 patients received the robot-assisted ureteropelvic dissociation plasty,and the disease was treated simultaneously.The operative time was(179±58)min.The time to drainage and catheter removal was(5.2±2.0)days and(7.5±2.7)days.No intraoperative complications occurred,no conversion toopen surgery.Clavien classification-Dindo(grade I-1)13 cases(13.1%).The average length of stay was(14±4)days and the average postoperative hospital stay was(7.0+2.2)days.The patients were followed up for(11.9±0.4)months without recurrence.Conclusion Robot-assisted laparoscopic surgery for the treatment of UPJO has the advantages of less trauma,clear operative field,high success rate of surgery,quick recovery and fewer complications,and can simulaneously deal with complicating diseases,with obvious clinical application advantages.