后腹腔镜下肾盂成形术在小儿肾积水手术中的应用

目的总结后腹腔镜下离断式肾盂成形术治疗小儿肾积水的经验。方法2003年12月至2005年9月收治肾积水患儿21例。男15例,女6例,平均年龄6．3岁。左侧14例,右侧7例。B超、IVU、放射性核素肾图检查均提示梗阻位于肾盂输尿管连接处。均采用后腹腔镜下离断式肾盂成形术。结果21例患儿中手术成功19例,中转开放手术2例。手术时间150～230 min,平均185 min。术中平均出血量＜20ml。术后3个月随访B超或放射性核素肾图,肾积水有明显改善。结论后腹腔镜下肾盂成形术有望成为治疗小儿肾积水的可靠方法,远期效果有待进一步随访。

Retroperitoneal laparoscopic pyeloplasty for pediatric hydronephrosis

To report initial experiences of retroperitoneal laparoscopic dismembered pyeloplasty for hydronephrosis. Methods There were 21 cases of hydronephrosis from December 2003 to September 2005 reviewed with male 15 cases, female 6 cases, mean age 6.3 years,left side 14 cases, right side 7 cases. Ultrasound, IVU and DTPA renograph showed ureter pelvic junction obstruction. Retroperitoneal laparoscopic dismembered pyeloplasty was performed in all cases. Results Retroperitoneal laparoscopic pyeloplasty was successfully conducted in 19 out of 21 patients. Two cases were converted to open surgery. Operation time ranged from 150 230 min, mean 185 min. Estimated blood loss was less than 20 ml. Ultrasound and renograph found hydronephrosis relieved 3 months later. Conclusions Retroperitoneal laparoscopic dismembered pyeloplasty is feasible to perform in pediatric hydronephrosis, though the long term result is still unknown.