腹腔镜手术在小儿泌尿外科的应用

目的　总结腹腔镜及腹腔镜辅助技术开展小儿泌尿外科手术的经验。　方法　腹腔镜手术 33例 ,男 2 4例 ,女 9例 ,平均年龄 4 .6岁。其中肾发育不良 5例 ,不能触及的隐睾 14例 ,肾积水肾盂输尿管连接处梗阻 11例 ,重复肾积水、重复肾伴重复输尿管囊肿各 1例 ,肾盂结石 1例。采用后腹腔镜肾、半肾切除 ,肾盂切开取石 7例 ;后腹腔镜辅助离断式肾盂成形术 11例 ;腹腔镜睾丸固定术或切除术 14例 ;气膀胱镜双输尿管移植术 1例。　结果　 33例手术均获成功 ,无 1例中转开放手术。术中出血量少 ,术后恢复快 ,术后第 1天进食。随访 2个月～ 3年 ,无并发症。　结论　腹腔镜及腹腔镜辅助手术治疗小儿肾积水、不能触及的隐睾等疾病 ,手术效果与开放手术相同。

Application of laparoscopic surgery in pediatric urology

Objective To report our laparoscopic and laparoscopic assisted urologic cases. Methods There were 33 laparoscopy cases,in 24 male and 9 female patients.The mean age were 4.6 years.Hypoplastic kidney were 5 cases,impalpable testis 14 cases,hydronephrosis 11 cases,duplicated kidney and duplicated kidney with ureterocole 1 case respectively,and pelvis stone 1 case.Retroperitoneal laparoscopic nephrectomy,heminephrectomy and pyelolithotomy ( 7 cases ),retroperitoneal laparoscopic assisted dismembered pyeloplasty ( 11 cases),laparoscopic orchiedopexy or orchiedectomy (14 cases),and laparoscopic pnuemovesical Cohens operation(1 cases) were conducted. Results 33 laparoscopic operations were completed successfully without conversion. Oral intake started on postoperative day 1.No serious complications occurred. Conclusions Laparoscopic techniques could be used for common pediatric urologic operations like hydronephrosis,impalpable testis ect.The surgical trauma and pain could be reduced and cosmetic effect improved.