后腹腔镜下肾盂成形术27例临床分析

目的 评价后腹腔镜肾盂成形术治疗肾盂输尿管连接部梗阻（UPJO）的临床应用价值.方法 回顾分析经后腹腔镜肾盂成形术治疗的27例UPJO患者的临床资料.患者中男性16例,女性11例,年龄16~43岁,平均26岁.左侧15例,右侧12例.异位血管压迫3例,合并肾盂结石2例.结果 27例手术均获成功.手术时间95~160 min,平均125 min;出血量60~110 ml,平均85 ml.术后住院时间6~11 d,平均8 d.随访6~24个月,平均18个月;UPJ吻合口无狭窄,肾积水得到改善.结论后腹腔镜肾盂成形术是治疗UPJO的有效、可行的微创手术,有可能替代开放手术,成为UPJO患者的首选术式,值得临床推广.

Clinical analysis of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction

Objective To evaluate the clinical value of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction （UPJO）. Methods The clinical data of 27 patients with UPJO who underwent retroperitoneal laparoscopic dismembered Anderson - Hynes type pyeloplasty were retrospectively analyzed. There were 16 men and 11 women, whose age ranging from 16 to 43 years （mean, 26 years） , and the left was 15 cases and the right wasl2 cases. There were 3 cases who had compression from crossing vessels and 2 were complicated with pelvic stones. Results Retroperitoneal laparoscopic pyeloplasty was performed successfully in all 27 cases. The operative time ranged from 95 to 160 min （mean, 125min）. The blood loss ranged from 60 to 110 ml （mean, 85m1）. The postoperative hospital stay time ranged from 6 to 11 day （ mean, 8d）. During the follow - up ranged from 6 to 24 months （ mean, 18 months）, no anastomotic stoma stricture of UPJ developed, and hydronephrosis was resolved. Conclusion Retroperitoneal laparoscopic pyeloplasty is feasible, effective and less invasive for UPJO with shorter hospital stay and faster convalescence. Retroperitoneal laparoscopic pyeloplasty should replace open surgery to become frist choice therapeutic method for ureteropelvic junction obstruction. It is worthy to be extended in clinic.