后腹腔镜下输尿管离断成形术治疗腔静脉后输尿管6例报告

目的探讨腔静脉后输尿管患者行后腹腔镜下输尿管离断成形术的疗效。方法回顾性分析6例腔静脉后输尿管患者的诊断及治疗经过,男性4例,女性2例。所有患者均经B超、逆行肾盂输尿管造影、CTU或MRU检查诊断为右侧腔静脉后输尿管,均伴有右肾积水和上段输尿管扩张。所有患者均行后腹腔镜下输尿管离断成形术。结果所有患者均顺利完成手术,无1例中转开放手术,术后所有患者均无明显并发症出现。术后1月拔除双J管,所有患者均恢复良好。平均随访18月,显示右肾积水显著减少。结论本组6例腔静脉后输尿管患者行腹膜后腹腔镜下输尿管离断成形术均获成功,该手术安全性高、疗效肯定、损伤小、术后恢复快,值得进一步推广。

Retroperitoneal laparoscopic dismembered pyeloplasty for patients with retrocaval ureter (a report of 6 cases)

Objective To evaluate the efficacy of retroperitoneal laparoscopic dismembered pyeloplasty in the treatment of retrocaval ureter.Methods The diagnosis and treatment of 6 patients with retrocaval ureter were retrospectively analyzed.Of the 6 patients,4 were male and 2 female.All cases were diagnosed as right retrocaval ureter with B ultrasound,retrograde,CT or MR urography,which showed hydronephrosis of right kidney with dilated upper ureter.All patients received retroperitoneal laparoscopic dismembered pyeloplasty.Results The operations were successfully performed in all patients with no major complications,and no case was converted to open surgery.The ureteral double-J stents were removed in all patients 1 month after the surgery.All patients recovered well,and the degree of hydronephrosis of the right kidney was dramatically decreased during the mean follow-up of 18 months.Conclusion Laparoscopic dismembered pyeloplasty can be successfully performed,and we believe that it is an effective surgical treatment with advantages of minimal invasion and rapid recovery.