肾盂输尿管连接部梗阻的选择性手术治疗(附97例报告)

目的：探讨肾盂输尿管连接部梗阻的手术治疗方法与效果.方法：报告经手术治疗97例肾盂输尿管连接部梗阻患者的临床资料.肾盂输尿管连接部狭窄引起梗阻者81例,纤维索带压迫者5例,输尿管肾盂高位连接者7,异位血管压迫者4例.共行手术105例次,Anderson-Hynes离断式肾盂成形术83例次,肾盂Y-V成形术6例,纤维条索松解术5例,异位血管切断肾盂复位术3例,经后腹腔镜肾盂成形术2例,肾切除术6例.结果：91例于术后随访3～72个月,87例痊愈.总治愈率95.6%.4例发生再狭窄,二次行肾盂成形术后均痊愈.结论：Anderson-Hynes离断式肾盂成形术是治疗肾盂输尿管连接部梗阻的首选术式,腹腔镜离断性肾盂成形术值得在临床上推广使用.

Operative treatment for ureteropelvic junction obstrction

Objective:To summarize our experience in the treatment of ureteropelvic junction obstrction.Methods:Clinical data of 97 patients with ureteropelvic junction obstrction were reviewed for etiology,clinical charaterristic and outcome of surgery.Etiology fingdings included ureteropelvic junction stricture in 81 cases,fiber chords in 5 cases,high locationg of the junction in 7 cases,and cross vessels in 4 cases.A total of 105 cases-times of surgical procedures were conducted: Anderson Hynes pelvioplasty(83 cases-times),Y-V pelvioplasty(6 cases),chords brisement(5 cases-times),ectopic vessel resection(3 cases),laparoscopic pyeloplasty(2 cases),and nephrectomy(6 cases).Results:91 patients were followed-up for 3 months to 6 years.Complete recovery was found in 87 patients,cure rate being 95.6%.4 patients underwent Anderson-Hynes pelvic plasty again due to stricture recurrence.All the patients with recurrence were completely cured.Conclusions:Anderson-Hynes pelvic plasty is the first choice of trenment for ureteropelvic junction obstrction.Laparoscopic pyeloplasty was safe and effctive for managing UPJO.