机器人辅助腹腔镜与输尿管软镜杂交手术治疗肾盂输尿管连接部梗阻合并肾结石

目的 探讨机器人辅助腹腔镜肾盂成型术与输尿管软镜杂交手术治疗合并肾结石的复杂肾盂输尿管连接部梗阻(UPJO)的可行性.方法 回顾分析我科于2012年5月至2013年8月收治的5例UPJO合并肾结石患者的临床资料,其中单发肾下极结石3例,多发结石2例.所有患者均采用机器人辅助腹腔镜肾盂成型术联合输尿管软镜取石杂交手术治疗.结果 5例均顺利完成手术,无严重手术并发症,实际手术时间平均(132.4±24.8)min,平均软镜取石时间(25.4±11.9)min,软镜均能完整探查肾脏集合系统,术后复查提示结石取净率达100％.术后随访6个月,所有患者不适症状均明显减轻,仅1例患者仍有2 cm肾积水,其余4例UPJ成型效果满意.结论 机器人辅助腹腔镜与输尿管软镜杂交手术治疗合并肾结石的复杂性UPJO安全可行.

Concomitant hybrid robotic-assistant laparoscopic pyeloplasty and flexible ureteroscopy for ureteropelvic junction obstruction combined with renal stones

Objective To evaluate the efficacy and safety of the robotic-assistant laparoscopic pyeloplasty(RALP) combined with flexible ureteroscopy(f-URS) for treatment of ureteropelvic junction obstruction(UPJO) with renal stones. Methods We retrospectively reviewed the records of 5 patients who underwent RALP and f-URS for UPJO combined with renal stones from May 2012 to August 2013.Three cases had solitary stones located at the lower calyx, and the other two had multiple stones. Results The operation was successful in all the 5 patients with no severe complications. The average total operation time was (132.4±24.8) min and the average f-URS time was (25.4±11.9) min. f-URS had full views of the collecting system with no blind area in all cases. Post-operative KUB and CT scan showed no residual stone fragments. The symptoms were greatly relieved in all patients after a 6-month follow-up postoperatively, with one patient still having 2 cm hydronephrosis; and the UPJO outcomes were satisfactory in the others. Conclusion Hybrid RALP combined with f-URS is safe and feasible for treatment of UPJO complicated with renal stones.