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[1]丁彦才,刘丽,李飞宇,等.经腹腹腔镜联合软镜治疗肾盂输尿管连接部梗阻合并肾结石[J].医学研究与战创伤救治(原医学研究生学报),2022,24(4):386-389.[doi:10.3969/j.issn.1672-271X.2022.04.011]
　DING Yan-cai,LIU li,LI Fei-yu,et al.Laparoscopic pyeloplasty combined with soft endoscope for the treatment of ureteropelvic J unction obstruction with renal calculi[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(4):386-389.[doi:10.3969/j.issn.1672-271X.2022.04.011]
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经腹腹腔镜联合软镜治疗肾盂输尿管连接部梗阻合并肾结石()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年4期
页码:
386-389
栏目:
临床研究
出版日期:
2022-08-30

文章信息/Info

Title:
Laparoscopic pyeloplasty combined with soft endoscope for the treatment of ureteropelvic J unction obstruction with renal calculi
作者:
丁彦才; 刘丽; 李飞宇; 杨涛; 马小云; 席海峰; 邵永祥; 王乔峰
作者单位：750021银川，解放军联勤保障部队第九四二医院泌尿外科（丁彦才、刘丽、李飞宇、杨涛、马小云、席海峰、邵永祥、王乔峰）
Author(s):
DING Yan-cai; LIU li; LI Fei-yu; YANG Tao; MA Xiao-yun; XI Hai-feng; SHAO Yong-xiang; WANG Qiao-feng
(Department of Urology, the 942th Hospital of the Joint Logistics Support Force，PLA，Yinchuan 750021,Ningxia Hui Autonomous Region, China)
关键词:
肾盂输尿管连接部梗阻; 腹腔镜肾盂成形术; 软镜; 肾结石; 取石术
Keywords:
ureteropelvic junction obstruction; laparoscopic pyeloplasty; soft endoscope;  renal calculi; lithotripsy
分类号:
R693.4
DOI:
10.3969/j.issn.1672-271X.2022.04.011
文献标志码:
A
摘要:
目的探讨腹腔镜肾盂成形联合电子膀胱软镜或输尿管软镜治疗肾盂输尿管连接部梗阻（UPJO）合并肾结石的安全性和有效性。方法回顾性分析2018 年1月至2021年12月解放军联勤保障部队第九四二医院收治的29例UPJO合并肾结石患者的临床资料，男13例，女16例，左侧16例，右侧13例；术前泌尿系CT三维重建（CTU）检查提示UPJO合并肾结石，肾集合系统分离5～8 cm，平均（5.5±2.1）cm，结石直径 0.8～3.5 cm，平均（1.5±0.9）cm。术中先利用腹腔镜游离出扩张的肾盂和输尿管上段，在肾盂拟裁剪处先切开1 cm，置入软镜，直视下用三边或四边套石网篮取出结石，较大结石取出困难时置入钬激光碎石，结石清除后采用Anderson‐Hyens法行腹腔镜肾盂成形术。结果29例患者均一期完成手术，结石均完全清除，1例术中置入戳卡导致肝损伤中转开放手术；手术时间120～260 min，平均（130.10±30.3）min，术后下地时间24~72 h，平均（38.5±16.2）h，平均住院时间（7.5±2.6）d。术后8周拔除双J管（D-J管），随访7~29个月，29例肾积水均明显改善，腰疼缓解，术后无严重并发症发生。结论腹腔镜肾盂成形术联合电子膀胱软镜或电子输尿管软镜同期治疗UPJO 合并肾结石安全、可靠，创伤小、恢复快，清石率高，值得临床推广应用。
Abstract:
ObjectiveTo investigate the safety and effectiveness of laparoscopic pyeloplasty combined with flexible electronic cystoscope or flexible ureteroscopy in the treatment of ureteropelvic J unction obstruction (UPJO) with renal calculi.MethodsA retrospective analysis of the clinical data of 29 UPJO patients with renal calculi admitted from January 2018 to December 2021, including 13 males and 16 females, 16 cases on the left side and 13 cases on the right side. Three-dimensional CT of the urinary system before operation Reconstruction (CTU) examination revealed that UPJO was associated with renal calculi. The renal collecting system was separated by 5 to 8 cm, with an average of (5.5±2.1) cm. And the stone diameter was 0.8 to 3.5 cm, with an average of (1.5±0.9) cm. Laparoscopy was used to free the expanded renal pelvis and upper ureter during the operation. The renal pelvis was incised 1cm at the intended cutting site, and an electronic soft cystoscope or electronic soft ureteroscope was placed. Under direct vision, it was taken out with a three-sided or four-sided stone basket. Holmium laser lithotripsy was inserted when larger stones were difficult to remove. After the stones were removed, the Anderson-Hyens method was used to perform laparoscopic pyeloplasty.ResultsAll 29 patients in this group completed the operation in one stage, and all the stones were completely removed. One case was converted to open surgery due to the implantation of a stick card during the operation. The operation time was 120-260 min, with an average of (130.1±30.3) min. The postoperative time to the ground was 24-72 h, with an average of (38.5±16.2) h. And the average hospital stay was (7.5±2.6) d. The double J tube (D-J tube) was removed 8 weeks after the operation. After a follow-up of 7-29 months, 29 cases of renal hydrops were significantly improved, the back pain was relieved, and no serious complications occurred after the operation.ConclusionLaparoscopic pyeloplasty combined with electronic soft cystoscope or electronic soft ureteroscopy for simultaneous treatment of UPJO complicated with kidney stones is safe and reliable.

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相似文献/References:

[1]马宏青,程 文,高建平,等.后腹腔镜肾盂成形术(附52例报告)[J].医学研究与战创伤救治(原医学研究生学报),2010,12(04):296.
　MA Hong-qing,CHENG Wen,GAO Jian-ping,et al.Retroperitoneal laparoscopic pyeloplasty (52 cases)[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2010,12(4):296.
[2]盛正成,沈天一,周昱霖,等.机器人辅助腹腔镜肾盂成型术联合加速康复治疗肾盂输尿管连接部梗阻[J].医学研究与战创伤救治(原医学研究生学报),2020,22(5):497.[doi:10.3969/j.issn.1672-271X.2020.05.010]
　SHENG Zheng-cheng,SHEN Tian-yi,ZHOU Yu-lin,et al.Robot-assisted laparoscopic pyeloplasty combined with enhanced recovery after surgery in the treatment of ureteropelvic junction obstruction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(4):497.[doi:10.3969/j.issn.1672-271X.2020.05.010]

备注/Memo

备注/Memo:
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更新日期/Last Update: 2022-09-06