The Use of Transureteroureterostomy in the Management of Complex Ureteral Problems

Purpose

Transureteroureterostomy has primarily been performed for benign disease in children with reflux or undergoing undiversion, and in adults with lower ureteral injury. We report the use of transureteroureterostomy for other than these traditional indications, including malignant disease.

Materials and Methods

Transureteroureterostomy was performed in 6 patients at the time of tumor resection to bypass large ureteral defects and in 4 as a secondary operation, usually associated with a ureteral leak after previous surgery.

Results

Complications related to transureteroureterostomy included 1 ureteral stricture and 1 ureteral leak. Good renal function was maintained with a mean followup of 77.9 months.

Conclusions

Our experience suggests that transureteroureterostomy can be useful for urinary diversion when a segment of lower ureter is involved with malignant disease.     

Transureteroureterostomy in childhood and adolescence: long-term results in 69 cases

PURPOSE: We analyzed a series of 69 transureteroureterostomies to evaluate long-term results and specify current indications. MATERIALS AND METHODS: Between 1969 and 1998 transureteroureterostomy was performed in 32 females and 37 males with a mean age of 8.6 years. Surgery was done to avoid repeat or difficult ureteral reimplantation after multiple failed procedures in 22 cases and to create a continent ureteral conduit for intermittent catheterization in 23. Other indications included undiversion in 8 cases, ureterocystoplasty in 6, diversion in 4, the Kropp procedure in 3, massively dilated megaureter in 2 and ureteral necrosis in 1. Of the 69 patients 6 were lost to followup and 63 were followed at least 1 year (median 6). RESULTS: A total of 63 patients were regularly monitored by clinical observation and morphological investigation, including ultrasound, excretory urography and cystography. In 50 cases (79.4%) results were good with no upper urinary tract dilatation. All initially normal donor ureters remained normal. Of 51 initially dilated donor ureters 40 (78.4%) improved or returned to normal, while 20 of 27 initially dilated recipient ureters (74.1%) improved or returned to normal. Serious complications in 3 cases (4.3%) involved anastomotic leakage, ischemic stenosis of the common ureteral trunk and progressive deterioration of function in 1 kidney requiring nephrectomy 3 years postoperatively. Reoperation was successful in the former 2 cases. CONCLUSIONS: With careful attention to technique transureteroureterostomy represents a safe and reliable procedure with well-defined indications in pediatric urology.     

Laparoscopic transureteroureterostomy: demonstration of its feasibility in swine

PURPOSE: To evaluate the feasibility of laparoscopic transureteroureterostomy (TUU) in a porcine model. MATERIALS AND METHODS: Nine female pigs had bilateral ureteral stents placed 3 weeks prior to surgery. At surgery, a left-to-right laparoscopic TUU was performed. Ureteral stents were placed across the anastomosis in seven cases. Six weeks after surgery, the stents were removed. After an additional 3 weeks, an excretory urogram, retrograde ureteropyelogram, and ureteroscopic examination of the anastomosis were performed. Serum creatinine assay and urine cultures were performed at regular intervals. Antibiotic prophylaxis was used for 1 week after each procedure. RESULTS: Of the nine animals, eight underwent successful laparoscopic TUU. Excretory urograms revealed prompt function and washout in all these cases. One animal developed an anastomotic stricture; in this animal, the ureters had remained nondilated after initial stent placement. Serum creatinine values remained within the normal range for all animals undergoing successful surgery. Additional complications included one urinary tract infection and one postoperative ileus, which were treated without difficulty. The operative time ranged from 2.5 to 6 hours, with shorter procedures later in the series. CONCLUSIONS: Laparoscopic TUU is practical in the porcine model. It may prove to be an alternative to an open TUU in patients with lower ureteral lesions when ureteroneocystostomy is not feasible.     

Retroperitoneoscopic renal surgery in children: our experience

BACKGROUND: Laparoscopic renal surgery has become an accepted approach for benign disease in adult and pediatric urology. We present our experience in renal laparoscopy in infants during the past 5 years and evaluate our series to establish the safety and efficacy of such procedures in children. MATERIALS AND METHODS: From August 1999 to December 2004, we performed 32 renal laparoscopic procedures on 31 children aged 12 months to 16 years (mean, 42 months). Twenty-seven patients underwent unilateral retroperitoneal nephrectomy; 1 child with Denis Drash syndrome underwent transperitoneal bilateral nephrectomy; 2 children underwent renal cyst unroofing; and 1 child with lymphoma underwent retroperitoneal laparoscopic renal biopsy. Indications for surgery were: renal function <9% in cases of unilateral nephrectomy; the prevention of renal neoplastic changes in the patient with Denys-Drash syndrome; symptomatic large renal cysts; and suspected lymphoma not diagnosed with a previous percutaneous biopsy. RESULTS: All procedures were completed laparoscopically. In 6 cases, the accidental opening of the peritoneum did not require conversion to open surgery. Intraoperative blood loss was minimal. One patient who underwent a retroperitoneal nephrectomy required a blood transfusion for postoperative bleeding into the retroperitoneal space. Twenty-four of 27 unilateral retroperitoneal nephrectomy patients were discharged on postoperative day 2. Mean follow-up was 30 months (range, 6-64 months). Cosmetic results were excellent in all patients and no long-term complications have been encountered so far. CONCLUSION: Laparoscopic urologic surgery may be performed in children with minimal morbidity, minimal postoperative discomfort, improved cosmetic results, and a short hospital stay.     

单纯性腹腔镜肾切除术治疗良性无功能肾22例报告

目的:总结单纯性腹腔镜肾切除术治疗良性无功能肾的临床应用经验。方法:回顾分析2003年9月至2009年11月施行单纯性腹腔镜肾切除术治疗22例良性无功能肾患者的临床资料。先天性肾盂输尿管连接处狭窄12例,输尿管结石6例,慢性肾盂肾炎2例,肾结核2例。结果:22例手术均获成功,无中转开放手术。手术时间65~180min,平均90min,术中出血25~150ml,平均55ml。住院4~12d,平均5d。无严重并发症发生及输血病例。1例经腹膜后途径患者术后拔除引流管后局部形成腹膜后血肿,再次在B超引导下置管引流。结论:单纯性腹腔镜肾切除术治疗良性无功能肾安全、微创,耐心细致的手术操作和对不同疾病采取个性化的治疗方案是手术成功的关键。     

机器人辅助腹腔镜黏膜下隧道法输尿管再植术的临床疗效分析

目的:介绍黏膜下隧道法机器人辅助腹腔镜治疗1例医源性输尿管下段狭窄患者和1例单侧重复肾重复巨输尿管合并肾积水患者的学习经验和手术疗效.方法:回顾性分析机器人辅助腹腔镜治疗1例膀胱肿瘤电切术后左侧输尿管下段狭窄、左肾积水,患者抗反流输尿管膀胱吻合采用黏膜下隧道包埋法;1例(左侧)原发性梗阻重复肾重复巨输尿管症患者,首先分离巨输尿管前面和两侧面,保留输尿管和腹壁间系膜先不离断,测量输尿管,剪裁,放入F7双J管,缝合成形后再离断系膜,采用黏膜下隧道包埋法与膀胱再吻合.结果:2例患者手术均成功,无中转开放,手术时间分别为165.8min、176.2min,其中机器人定位时间30min;出血量分别为12.4ml、20.8ml;术后引流管拔除时间第1例5d,第2例6d,2例患者均无明显漏尿,术后尿管拔除时间为14d.术后随访6个月,复查CT和彩超显示肾积水明显减轻,未见输尿管吻合口狭窄和输尿管反流.结论:机器人辅助腹腔镜黏膜下隧道法输尿管膀胱再植术治疗复杂的输尿管下段狭窄和复杂的巨输尿管症安全有效.     

Laparoscopic sigmoid colectomy for chronic diverticular disease.

BACKGROUND: The feasibility of laparoscopic sigmoid colectomy for diverticular disease has now been well established. We report herein our experience with laparoscopic sigmoid colectomy in 100 patients who underwent laparoscopic colectomy for chronic diverticular disease. METHODS: A retrospective review was performed of a 7-year period from January 1995 to June 2002. Chronic diverticular disease was treated with laparoscopic sigmoid colectomy in 100 patients. The setting was a community hospital. All cases were performed by 1 of 2 colorectal surgeons. All laparoscopic sigmoid colectomy patients received lighted ureteral stents placed preoperatively that were removed at the end of surgery. RESULTS: Mean age was 61.6 years. The male to female ratio was 38:62. The mean estimated blood loss was 138 mL, liquid diet was tolerated for 2.4 days, and hospital length of stay was 4.6 days. The mean operative time for laparoscopic sigmoid colectomy was 196 minutes. Relative complications for laparoscopic sigmoid colectomy are as follows: anastomotic leak in 2 (3.0%) patients, hematuria in 95 (95%) with an average duration for 3.1 days, urinary tract infection in 6 (6%), and ureteral injury in 1 (1%). The mean operating room charges in the laparoscopic sigmoid colectomy patients was dollars 9,643. CONCLUSION: We recommend laparoscopic sigmoid colectomy as the modality of treatment for chronic diverticular disease. Laparoscopic sigmoid colectomy appears to be a reliable, safe, and efficacious treatment modality for chronic diverticular disease. The operative time for laparoscopic sigmoid colectomy is decreasing as surgeons gain more experience.     

改良单孔法腹腔镜手术治疗儿童腹股沟疝的应用体会

【摘要】 目的 探讨改良单孔法腹腔镜手术治疗小儿斜疝的安全性及有效性。方法 2006年2月~2010年10月,对77例小儿腹股沟斜疝采用改良单孔法腹腔镜手术,经脐部置入3 mm或5 mm腹腔镜监视腹腔,在体外使用普通开放手术针持夹持大圆针,在缺损内环口体表刺入并带入4号丝线,在腹膜外环形高位缝扎内环口。结果 77例均手术成功。术中发现并同时处理对侧隐匿性斜疝22例(31.4%)。平均手术时间48例单侧疝13 min(7~19 min),29例双侧疝21 min(14~31 min)。术后住院时间平均48 h(26~52 h),未发现有脐戳孔疝、戳口处血肿、腹膜外气肿、阴囊血肿等并发症。35例获得随访6~36月,平均22.6月,无并发症及复发病例。结论 改良单孔法腹腔镜手术治疗小儿斜疝安全、可靠,创伤少,效果好,容易学习掌握。     

Mini-invasive surgery of the retroperitoneal space in children]

Although laparoscopic surgery now represents today an essential surgical technique, its use remains limited in urology and especially in pediatric urology for many reasons, main because of the lack of indications. After a large experience acquired in abdominal laparoscopic surgery, and because we were convinced of the advantages offered by this new mini-invasive approach, we have tried to develop it for the retroperitoneal space. METHODS: Over a five-year period we performed 88 retroperitoneal procedures in children:--50 nephrectomies (44 total, 10 partial) for the following indications: 15 polycystic dysplastic kidney, 13 kidney destroyed by reflux, 18 by obstruction, hypertensive uropathy 3, pyonephrosis 1.--5 renal cystectomies, 3 pyelolithotomies, 2 pyeloureteral obstructions, 2 adrenalectomies, 1 retrocaval ureter, 25 varicoceles. The age range was 2 months to 16 years (mean: 3.7 years, 25 children under 1 year). The patients were placed in the lateral debubitus. The retroperitoneal space was created by dissection under direct vision, then insufflation was performed directly in the retroperitoneal space without balloon. Three or four ports were used except for varicocelectomy which was performed with only one port and an operating channel telescope. RESULTS: Follow-up range was 6 months to 5 years. The mean operating time was 96 minutes (35 to 210 min.). Average postoperative stay was 2 days. Conversion was needed in 7 cases (8%). Operative incidents consisted of one duodenal perforation, one ureteral burn, 21 peritoneal perforations (24%). There were 5 postoperative complications (2 urinomas after partial nephrectomy, 1 hydrocele, 1 varicocele recurrence, 1 recurrent stones) not related to the technique. 3 cases needed reoperation (ureteral injury, varicocele recurrence, recurrence of cystine stones) with good result. CONCLUSION: Like other laparoscopic techniques, retroperitoneoscopy requires a training: it remains delicate in children because of the reduced working space and the fragility of the peritoneum. However the advantages seem sufficiently obvious for us to recommend and promote this procedure.     

Robot-assisted laparoscopic ipsilateral ureteroureterostomy for ectopic ureters in children: description of technique

Abstract Purpose: We report our experience and present our technique with the robot-assisted laparoscopic ipsilateral ureteroureterostomy (IUU) in the management of ureteral duplication with ectopia in children. Patients and Methods: We reviewed our institutional experience for all patients who underwent a robot-assisted laparoscopic IUU at the University of Minnesota Amplatz Children's Hospital between December 2010 and October 2011. An intraoperative, three-port technique was used after a ureteral stent was placed into the ipsilateral lower pole. Demographic information, diagnosis, operative time, hospital course, complications, and follow-up were all evaluated. Results: Our series included four female patients and one male patient with a mean age of 61 months (6 to 182?mos). All five had a diagnosis of upper pole ectopic ureters, one of which was associated with an ureterocele. Mean total operative time was 225 minutes (181 to 253?min), and mean hospital stay was 1.2 days (1-2 days). There were no intraoperative complications. In follow-up, at the time of ureteral stent removal, pyelonephritis developed in one patient, but all patients had resolution of their presenting symptoms including urinary tract infections and incontinence. A significant reduction in upper pole hydronephrosis was seen in all patients. Conclusions: Our experience indicates that robot-assisted laparoscopic IUU is safe and effective in the management of ureteral duplication anomalies in children.     

后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石27例报告

目的：评价后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石的有效性及安全性。方法：2003年9月-2008年6月采用后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石27例,对手术方法及并发症进行回顾性分析。结果：27例手术均获成功,平均手术时间（92．6±23．3）min,术后3天的结石清除率为100％（27／27）,术后3天血红蛋白下降平均值（0．38±0．21）g／L。术后有1例（3．70％）出现38．5℃以上发热,1例（3．70％）出现漏尿。结论：后腹腔镜输尿管切开取石术治疗嵌顿性输尿管上段结石疗效满意,安全性较高。     

Treatment of distal ureteral stricture by laparoscopic ureterovesical reimplantation

Introductionto analyse the results achieved to treat iliac or pelvic ureteric stricture using laparoscopic reimplantation of the ureter in a psoic bladder.Material and methodin a four-year period, we performed laparoscopic ureteral reimplantation in a psoic bladder in 6 patients (right/left 1:1; male/female 1:2; mean age 59.2 years, range 47-87). In 4 cases the lesion was iatrogenic and in 2 cases idiopathic. Ureteral resection with bladder cuff and cystorraphy followed by ipsilateral lymph node dissection was performed in idiopathic cases or those with history of previous urothelial tumour (4 cases in total) before ureteral reimplantation. Bladder was extensively mobilized and fixed to minor psoas tendon before performing ureteroneocystostomy. Mixed intra and extravesical technique with submucosal tunnel (Politano) was used in a case and in the remaining 5 cases extravesical technique with submucosal tunnel (Goodwin) was used. Mean follow-up was 26 months (range 18-34).Resultsthere was no need to convert to open surgery. Time of surgery was 230 minutes in the case treated with Politano ureteroneocystostomy and 120 (range 75-150) in those treated purely extravesically. The mean hospital stay was 3.2 days (range 2-5). There were no intra or postoperative complications. Histologic assessment always revealed ureteral fibrosis and in 2 cases accompanying granulomatous inflammation and dysplasia. No patient suffered re-stricture or impairment in renal function during follow-up.Conclusionslaparoscopic ureteral reimplantation is an effective and safe minimally invasive technique to treat benign distal stricture of the ureter. Simplicity of extravesical reimplantation has an advantage over its intravesical counterpart.     

Laparoscopic bladder flap ureteral reimplantation: survival porcine study

PURPOSE: The bladder or Boari flap is a useful technique for ureteroneocystostomy when the distal ureter is too short to reach the bladder without undue tension. We report our experience with laparoscopic Boari flap ureteroneocystostomy in the chronic porcine model. MATERIALS AND METHODS: Six female farm pigs underwent unilateral laparoscopic Boari bladder flap ureteroneocystostomy. Refluxing direct ureteral reimplantation was performed in the initial 3 animals. In the next 3 animals a submucosal tunnel was formed to achieve nonrefluxing ureteroneocystostomy into the Boari flap. The animals were sacrificed 6 weeks after surgery. At sacrifice ascending cystography, ipsilateral antegrade pyelography and autopsy examination of the ureteroneocystostomy site was performed. RESULTS: No intraoperative or postoperative complications were noted. Average operative time was 140 minutes. Postoperatively serum creatinine and hemoglobin were normal in all pigs. All 3 animals with direct ureteroneocystostomy into the Boari flap had free reflux into the kidney and all 3 with a submucosal tunnel reimplant had no reflux on ascending cystography and free drainage on antegrade pyelography. Autopsy confirmed a patent anastomotic site in all 6 cases. CONCLUSIONS: Laparoscopic ureteroneocystostomy using the Boari bladder flap technique is feasible. Our survival porcine model confirms the successful application of the refluxing and nonrefluxing technique of ureteral reimplantation. Clinical application of the technique has the potential to decrease patient morbidity associated with traditional open surgery.     

Surgery for urologic complications following radiotherapy for gynecologic cancer

Urologic surgery was necessitated by complications following radiotherapy for gynecologic cancer in 17 patients. Four had recurrent malignant disease and 13 were without evidence of malignancy. The median interval to onset of the urologic complications was 18 (range 0-144) months. Ileal substitution was performed because of bilateral ureteral obstruction in two cases, and transureteroureterostomy for unilateral obstruction in one case. Vesicovaginal fistula was present in 14 patients, who underwent urinary diversion--cutaneous ureterostomy and ligation of the other ureter (6 cases), cutaneous ureterostomy and transureteroureterostomy (3) and ileal conduit diversion (5). The immediate morbidity and mortality were determined by the patients' general state of health rather than by presence or absence of recurrent malignant disease. The choice of diversion procedure should be guided by the patient's fitness, the status regarding recurrence of malignancy and the distribution of function between the two kidneys.     

The reimplanted ureter as a catheterizing stoma

Some current trends in the management of neurogenic bladder have been toward utilization of the urinary bladder as a storage device with a continent catheterizing stoma. This study presents a procedure using the now standard Cohen ureteral reimplantation, followed some 6 weeks later by transureteroureterostomy and distal ureteral stomal formation, after the method of Mitrofanoff. This staged procedure appears to have allowed the recently reimplanted ureter to be divided and brought to the skin as a viable catheterizing stoma. We believe that this experimental study has demonstrated that the Cohen technique of ureteral reimplantation is a reasonable antecedent to the use of transureteroureterostomy and distal ureteral stoma creation for continent catheterization. Monfort has demonstrated this clinically in one patient, and we feel that this technique deserves more extensive clinical trials.     

Laparoscopic Ureteroneocystostomy for Ureteral Injuries After Hysterectomy

Objectives:

To examine the feasibility of early laparoscopic ureteroneocystostomy for ureteral obstruction due to hysterectomy injury.

Methods:

We retrospectively reviewed a 10-y experience from 2 institutions in patients who underwent early (<30 d) or late (>30 d) laparoscopic ureteroneocystostomy for ureteral injury after hysterectomy. Evaluation of the surgery included the cause of the stricture and intraoperative and postoperative outcomes.

Results:

A total of 9 patients with distal ureteral injury after hysterectomy were identified. All injuries were identified and treated as early as 21 d after hysterectomy. Seven of 9 patients underwent open hysterectomy, and the remaining patients had vaginal and laparoscopic radical hysterectomy. All ureteroneocystostomy cases were managed laparoscopically without conversion to open surgery and without any intraoperative complications. The Lich-Gregoir reimplantation technique was applied in all patients, and 2 patients required a psoas hitch. The mean operative time was 206.6 min (range, 120–280 min), the mean estimated blood loss was 122.2 cc (range, 25–350 cc), and the mean admission time was 3.3 d (range, 1–7 d). Cystography showed no urine leak when the ureteral stent was removed at 4 to 6 wk after the procedure. Ureteroneocystostomy patency was followed up with cystography at 6 mo and at least 10 y after ureteroneocystostomy.

Conclusion:

Early laparoscopic ureteral reimplantation may offer an alternative surgical approach to open surgery for the management of distal ureteral injuries, with favorable cosmetic results and recovery time from ureteral obstruction due to hysterectomy injury.     

Ureteroscopy is safe and effective in prepubertal children

PURPOSE: We present our experience performing ureteroscopy in prepubertal children. MATERIALS AND METHODS: We performed a retrospective cohort study of children 12 years or younger who underwent ureteroscopy at 2 institutions between 1993 and 2003. Patient demographics, indications for surgery, operative technique, surgical outcomes and complications were recorded. RESULTS: A total of 39 boys and 32 girls underwent 34 flexible and 47 rigid ureteroscopies. Retrograde access was obtained in 77 procedures, while 4 were performed via an antegrade approach. Mean age was 7.5 years (range 1 to 12) and mean followup was 2.2 years (0.5 to 10). Endoscopic lithotripsy was performed in 65 cases, with a success rate of 98%. A ureteral stent was placed postoperatively in 55 patients. Endoscopic incision was performed for a ureteral stricture in 3 patients and for ureteropelvic junction obstruction in 6. An obstructing fibroepithelial polyp was found in 2 patients, 1 underwent removal of a foreign body and 4 did not have intraluminal pathology. Dilation of the ureteral orifice was required in 23 cases (30%). There were no intraoperative ureteral injuries. One patient had development of a ureteral stricture (complication rate 1.3%) that was successfully treated endoscopically. CONCLUSIONS: Rigid and flexible ureteroscopy can be performed safely and effectively in prepubertal children. Successful outcomes can be obtained for calculi that are similar to those in the adult population. Ureteroscopic treatment can be effective in selected children with intraluminal obstruction. To our knowledge this is the largest series in the literature to document outcomes of ureteroscopy in this age group.     

The implications of lighted ureteral stenting in laparoscopic colectomy.

OBJECTIVE: The placement of indwelling ureteral catheters during colorectal surgery has been recommended for prevention of ureteral injuries. With the advent of laparoscopic colectomy (LCo), the role of preoperative placement of lighted ureteral stents (LUS) has also become commonplace. We sought to evaluate the value of lighted ureteral stent placement in laparoscopic colectomy. METHODS: Sixty-six patients underwent LCo with LUS inserted preoperatively. Stents were removed in the immediate postoperative period. Two surgeons performed all the colectomies; 32 patients were males and 34 were females. Fifty patients underwent sigmoid colectomy, 4 had abdominoperineal resection, 4 had right colectomy, and 1 each had transverse or subtotal colectomy. Eighteen patients had a diagnosis of cancer, 34 had diverticular disease, and 14 had neoplastic polyps. Forty patients had bilateral and 26 had unilateral stent placement. A review of the incidence of ureteral injuries, hematuria, and anuria as the cause of acute renal failure was accomplished, comparing the unilateral and bilateral stented groups. RESULTS: One (1.5%) patient suffered a left ureteral laceration during sigmoid colectomy. This was managed successfully with stent reinsertion. Sixty-five (98.4%) patients had gross hematuria lasting 2.93 days (1 to 6 days). The cost of bilateral stent placement was $1,504.32. A statistically significant difference occurred in the duration of hematuria (days) between patients who had unilateral (2.5 +/- 0.82) and bilateral stent placement (3.37 +/- 1.05), (P < 0.001). Four patients suffered from anuria, 2 required renal support needing hemodialysis for 3 to 6 days, 3 (75%) had bilateral stents, and 1 (25%) had a unilateral stent. CONCLUSIONS: We recommend the placement of lighted ureteral stents as a valuable adjunct to laparoscopic colectomy to safeguard ureteral integrity. Transient hematuria is common but requires no intervention. Reflux anuria occurs infrequently and is reversible.     

后腹腔镜输尿管切开取石术的手术技巧

目的:总结后腹腔镜输尿管切开取石术的手术经验,分析其操作技巧。方法:回顾分析为86例复杂输尿管上段结石患者行后腹腔镜输尿管切开取石术的临床资料。结果:86例手术均获成功,镜下操作时间平均(40.34±9.35)min,术中出血量平均(15.17±9.05)ml,术后导尿管拔除时间平均(3.73±0.81)d,平均住院(5.73±0.98)d。术中腹膜破损1例,术后尿漏2例,均持续1 d;无严重并发症发生。结论:后腹腔镜输尿管切开取石术安全有效,具有患者创伤小、康复快的优点,可作为输尿管上段复杂结石的首选治疗方案。通过一定的技巧,可加快手术进程,缩短手术时间。     

腹腔镜小儿腹股沟斜疝内环口结扎术85例体会

目的：探讨腹腔镜内环口结扎术治疗小儿腹股沟斜疝的临床应用价值。方法：回顾分析2005年8月至2006年10月85例腹股沟斜疝患儿行腹腔镜内环口结扎术的临床资料。结果：85例全部治愈。手术时间单侧5～15min，平均10min；双侧12—28min，平均18min。术后住院1—3d，平均住院2．4d。随访6—28个月，无一例复发。结论：腹腔镜小儿腹股沟斜疝内环口结扎术具有效果好、损伤小、恢复快、住院时间短、复发率低等优点。