楔形切除肾门后唇修复医原性肾盂撕脱伤(附七例报告)

Repairation of iatrogenic pelvis tear with the wedge resec tion of the back labium of renal hilum (report of 7 caese)

目的 总结楔形切除肾门后唇修复医原性肾盂撕脱伤的经验。 方法 男 5例 ,女 2例。平均年龄 45岁。肾结石手术取石中撕脱肾盂 6例 ,输尿管硬镜取石撕脱 1例。均采用楔形切除肾门后唇约 3 .0cm× 2 .0cm ,修补肾盂撕脱 ,肾造瘘管作支架 ,留置 4～ 5周。 结果 7例手术修补均成功 ,平均手术时间 13 0min ,平均出血 3 0 0ml,术后无漏尿。随访 3～ 3 6个月 ,IVU显示无肾盂狭窄及肾积水。 结论 此术式不阻断肾蒂 ,出血少 ,术野清晰 ,肾门出口宽大 ,肾盂修补吻合便利 。

ObjectiveTo evaluate wedge resection of th e back labium renalis in the repairation of iatrogenic pelvis tear. MethodsFrom October 1999 to February 2002,7 cases of iatrogenic pel vis tear were repaired with wedge resection of the back labium of renal hilum.Th ere were 5 male patients and 2 female with an average age of 45.The tear occurre d during lithotomy for pelvis stone in 6 and transureteroscopic lithotripsy in 1.ResultsThe mean operative time was 130 min and the m ean blood loss 300 ml,postoperative IVU showed no obstruction of the renal pelvi s,and the renal function has been normal.All patients have been followed up for 3 months to 3 years.Neither hydronephrosis nor renal pelvis obstruction has been noted.ConclusionsThe procedure has the advantages of no need of predicle occlusion,less bleeding,a clear operation field,easy repaira tion,and the avoidance of pelvis obstruction.