经腹入路腹腔镜下肾盂成形术治疗肾盂输尿管连接部梗阻的技巧探讨与经验总结(附53例报告)

目的:探讨经腹入路腹腔镜下肾盂成形术治疗肾盂输尿管连接处梗阻的应用技巧,并总结其临床经验。方法:回顾分析2010年1月至2018年1月采用经腹入路腹腔镜下肾盂成形术治疗53例肾盂输尿管连接部梗阻患者的性别、年龄、手术时间、失血量、住院时间、并发症等临床资料及随访资料。其中男29例,女24例;平均(18.0±5.7)岁,左侧30例,右侧22例,双侧1例。结果:53例手术均采用经腹入路顺利完成腹腔镜手术,无中转开放手术。手术时间平均(158.4±56.8)min,失血量平均(9.6±5.8)mL,术后平均住院(5.9±3.1)d。术后无严重并发症发生,术后随访,肾积水均不同程度减轻,2例患者术后出现反复泌尿系统感染,拔除双J管后治愈。结论:经腹入路腹腔镜下肾盂成形术是治疗肾盂输尿管连接处梗阻安全、有效的术式,手术效果可靠,值得推广应用。

The skill and experience of transperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction:with a report of 53 cases

Objective:To explore the application skills of transperitoneal laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction(UPJO)and sum up the clinical experiences.Methods:A retrospective analysis was made on the clinical and follow-up data,such as gender,age,operation time,blood loss,hospitalization time and complications,of the 53 patients who suffered from UPJO and underwent transperitoneal laparoscopic pyeloplasty from Jan.2010 to Jan.2018.The 53 patients,29 males and 24 females,covered 30 cases on the left side,22 cases on the right side and 1 case on the double sides.The mean operating age was(18.0±5.7)years old.Results:All the 53 operations of transperitoneal laparoscopic pyeloplasty were performed successfully without conversion to open surgery.The operating time was(158.4±56.8)min,the blood loss was(9.6±5.8)mL,and the postoperative hospital stay was(5.9±3.1)d.Serious postoperative complications were not found.The postoperative follow-up revealed that degrees of hydronephrosis were reduced at different extent.Only 2 patients suffered from postoperative recurrent urinary tract infections,and healed after removal of double J tube.Conclusion:The transperitoneal laparoscopic pyeloplasty is a safe and effective operation in the treatment of UPJO.It is an operation with reliable effects and is worth promotion.