后腹腔镜肾盂成形术治疗儿童肾盂输尿管连接部狭窄15例报告

目的探讨后腹腔镜下离断性肾盂成形术即Anderson-Hynes手术治疗儿童肾盂输尿管连接部梗阻（UPJ0）的疗效。方法采用后腹腔镜下Anderson-Hynes手术治疗肾盂输尿管连接部梗阻所致中、重度肾积水的患者15例。病程2周～5年，均为腰部钝痛不适就诊，所有患者均经影像学明确UPJ0诊断。结果后腹腔镜离断式肾盂成形术耗时120～230（155．0±37．4）min，术中出血20-55（35．0±9．2）mL。无中转开放手术。术后2～4d拔出腹膜后引流管，切口均一期愈合，术后8～10周拔出D-J管，无漏尿及吻合口狭窄，随访3～24（18．0±4．1）个月，B超及静脉肾盂造影（IVU）提示积水改善、肾功能恢复。结论后腹腔镜离断式肾盂成形术在手术创伤、住院时间、术后恢复等方面优于开放手术，有望替代开放术式。

Retroperitoneal iaparoscopic dismembered Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction in children

Objective To evaluate the efficacy of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction（UPJO） in children. Methods 15 cases of UPJO with 2 weeks-5 years pathogenesis were treated with retroperitoneal laparoscopic pyeloplasty with Anderson-Hynes technique. All patients had radiographic evidence of obstruction with signs and symptoms. Results All operations were performed successfully, and no serious complications occurred during or after the operations. The average operating time was （155.0±37.4）min （ranging 120-230 rain）, average blood loss was （35.0±9.2） mL （ranging 20-55 mL）. No case was turned to open surgery. During the follow-up of 3-24（average 18.0±4.1） months, all patients demonstrated improved drainage with no evidence of obstruction on diuretic renography and/or excretory urography. Conclusions Retroperitoneal laparoscopic pyeloplasty with Anderson-Hynes technique might be a valuable alternative to open pyeloplasty for UPJO, which is safe, effective and minimally invasive, but the long-term outcome must be assessed before this procedure is definitively validated.