后腹腔镜Anderson—Hynes术在肾盂输尿管连接部梗阻治疗中的应用

目的介绍后腹腔镜Anderson-Hynes术治疗肾盂输尿管连接部梗阻的方法和初步经验。方法2006年3月至2007年12月，采用后腹腔镜Anderson—Hynes肾盂成形术治疗肾盂输尿管连接部梗阻患者11例，其中男性7例，女性4例，平均年龄27岁，重度积水8例，轻中度积水3例。结果11例手术均获成功，手术时间为120～300min，平均为180min，术中出血量为20～80ml，平均为50ml。术中术后无严重并发症发生。术后随访3～20个月，腰部疼痛症状均消失，复查B超有2例肾脏积水完全消失，其余9例复查静脉肾盂造影肾盂积水均较术前明显减轻，未见吻合口狭窄结论后腹腔镜Anderson—Hynes肾盂成形术治疗肾盂输尿管连接部梗阻技术可行、安全有效，对于有丰富腹腔镜技术经验的术者可取代开放手术。

Retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for ureteropeivic junction obstruction

objective To introduce the experience in the treatment of retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for ureteropeivic junction obstruction （UPJO）. Methods The clinical datum of 11 cases with UPJO were collected from March 2002 to December 2006, the patients were diagnosed as UPJO by intravenous phelogram （IVP）, retrograde pyelography or CT before operation.7 patients were male and 4 were female. The mean age was 27 years. There were 8 patients had severe hydronephrosis and 3 had mild to moderate hydronephsosis, Retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty was performed to resect stricture part and redundant part of the pelvis, end-to-end anastomosis of the ureter and pelvis was performed. Result Retroperitoneoscopic pyeloplasty was performed successfully in all 13 cases.The mean operative time was 180 min （range from 120 to 300 min ）.The mean blood loss was 50 ml （range from 20 to 80 ml ）.No severe complication was noted. All patients were available in the follow-up of 3 to 20 months. All the patients reported a complete resolution of pain. There was no stricture at UPJ by IVU. Conclusion Retroperitoneat laparoscopic Anderson-Hynes dismembered pyeloplasty for ureteropeivic junction obstruction is feasible, safe and effective. It may take the place of conventional open surgery.