摘要
目的:探讨俯卧位背侧入路后腹腔镜肾盂成形术治疗肾盂输尿管连接部梗阻(UPJO)的临床应用价值。方法:回顾性分析18例UPJO患者的临床资料。其中男12例,女6例,年龄18～65岁,平均31岁。所有患者行肾脏超声、静脉肾盂造影或多层螺旋CT尿路成像和逆行造影检查,其中2例行逆行造影证实迷走血管压迫,8例无症状患者行同位素肾图证实上尿路梗阻。结果:18例均在后腹腔镜下顺利完成手术。手术时间85～205 min,平均125 min;术中出血量35～80ml,平均54 ml;术后住院6～12天,平均8.7天。围手术期未出现并发症。术后4～6周拔除双J管。随访时间9～20个月,平均14.7月,1 7例痊愈,总治愈率(94.4%)。1例发生再狭窄,二次行开放手术治愈。结论:俯卧位背侧入路后腹腔镜离断性肾盂成形术治疗UPJO安全可行。经背侧入路后腹腔镜手术的成功实施为临床手术路径的研究提供一种新的思路。
Objective：To evaluate the clinical effects of the posterior approach retroperitoneoscopic pyeloplasty in the prone position for ureteropelvic junction（UPJ）obstruction. Methods：The clinical of data of 18 patients with UPJ obstruction who underwent posterior approach retroperitoneoscopic dismembered Anderson-Hynes type pyeloplasty in the prone position for ureteropelvic junction obstruction were retrospectively analyzed. There were 12 men and 6 women,and their age ranged from 18 to 65 years old,the average age was 31 years. All patients were performed renal uhrasonography,intravenous pyelography（IVP） or multi-slice spiral CT urography（MSCTU） and retrograde pyelography, which 2 patients had compression from aberrant vessel by retrograde pyelography was confirmed. Besides,8 asymptomatic patients had obstruction of upper urinary tract which were examined by isotope diuretic renography. Results：The procedures were completed in all patients. The mean operative time was 125 minutes（range 85-205）. The estimated blood loss was 54 ml（range 35-80）. The mean hospital stay was 8. 7 days （range 6-12）. No perioperative complications occurred. The remove double-J was 4-6 months. At a mean followup of 14.7 months（range 9-20）. Complete recovery was found in 17 patients,cure rate being 94.4%. 1 patients underwent open pyeloplasty again due to stricture recurrence. Conclusions：The posterior approach of retroperitoneoscopic pyeloplasty in the prone position for ureteropelvic junction（UPJ）obstruction is a safe and feasible procedure. The successful implementation of posterior approach retroperitoneoscopy for clinical research of surgery approach provides a new idea.
出处
《临床泌尿外科杂志》
北大核心
2011年第2期116-118,共3页
Journal of Clinical Urology
