后腹腔镜下离断式肾盂成形术

目的探讨后腹腔镜下肾盂成形术的临床疗效. 方法腹腔镜下通过后腹腔途径对9例肾盂输尿管连接部狭窄行离断式肾盂成形术并对技术进行改进. 结果 9例手术均获成功,手术时间110～240 min,平均160 min.术中出血量30～80 ml,平均50 ml.术后住院8～18 d,平均11.2 d.术后并发症:皮下气肿(合并阴囊气肿)1例,漏尿2例.术后1～10个月B超示术侧肾盂无积水5例,轻度积水2例,中度积水2例.3例术后5个月IVU显示吻合口通畅. 结论后腹腔镜肾盂成形术微创、效果好,值得推广.

Retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty

Objective To investigate the clinical results of retroperitoneal laparoscopic pyeloplasty. Methods Retroperitoneal approach laparoscopic Anderson-Hynes dismembered pyeloplasty with some modifications was performed in 9 cases of ureteropelvic junction (UPJ) obstruction. Results All the operations were accomplished uneventfully. The operation time was 110~)240 min (mean, 160 min), and the estimated intraoperative blood loss, 30~80 ml (mean, 50 ml). The postoperative hospital stay was 8~18 d (mean, 11.2 d).Surgical complications included 1 case of subcutaneous emphysema (with scrotal emphysema) and 2 cases of urinary leakage. B-ultrasound examinations at 1~10 months after the procedure showed hydronephrosis was completely cured or significantly improved. Intravenous urethrography (IVU) findings in 3 cases revealed patent anastomotic stomas at 5 months after operation. Conclusions Retroperitoneal approach laparoscopic nephropyeloplasty has the advantages of minimal invasion, high efficacy and quick postoperative recovery, which is worth further clinical application.