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[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):296-298.
　MA Hong-qing,CHENG Wen,GAO Jian-ping,et al.Retroperitoneal laparoscopic pyeloplasty (52 cases)[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2010,12(04):296-298.
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后腹腔镜肾盂成形术(附52例报告)()
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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12卷
期数:
2010年04期
页码:
296-298
栏目:
出版日期:
2010-07-20

文章信息/Info

Title:
Retroperitoneal laparoscopic pyeloplasty (52 cases)
文章编号:
1672-271X(2010)04-0296-03
作者:
马宏青1 ; 程 文1 ; 高建平1 ; 张征宇1 ; 葛京平1 ; 曹正国2
1.210002 江苏南京，南京军区南京总医院泌尿外科;2.230003 安徽合肥，安徽省立医院泌尿外科
Author(s):
MA Hong-qing1; CHENG Wen1; GAO Jian-ping1; ZHANG Zheng-yu1; GE Jing-ping1;  CAO Zheng-guo2
1.Department of Urology,Nanjing General Hospital of Nanjing Military Command,PLA,Nanjing,Jiangsu 210002,China;2.Department of Urology,Anhui Provincial Hospital,Hefei,Anhui 230003,China
关键词:
肾盂输尿管连接部梗阻; 后腹腔镜
Keywords:
ureterope lelvic junction obstruction;  retropor itoneal laparoscopy
分类号:
R699.2
DOI:
-
文献标志码:
A
摘要:
目的 进一步探讨后腹腔镜肾盂成形术的临床应用价值。方法 回顾性分析52例后腹腔镜肾盂成形术的临床经过，结合国内外相关文献复习，总结该术式的方法学，病因学、适应证、禁忌证与注意事项等方面的临床经验与国内外的最新科研成果。52例中，男35例、女17例。年龄9～44岁，平均16岁。左肾37例、右肾15例。B超显示:肾盂积水扩张<15 mm(轻度)8例、15～30 mm(中度)33例、>30 mm(重度)11例。静脉肾盂造影(IVU)检查:<30 min显影良好34例，30～120 min淡显影13例，>120 min未显影5例。结果 52例手术均顺利完成。手术时间130～250 min，平均162 min；术中出血量35～110 ml，平均65 ml；术后住院时间5～8天，平均7天。52例随访3～15个月。ＩＶＵ显示肾盂输尿管连接部(ＵＰＪ)术后无梗阻，30 min内显影良好46例，30～120 min淡显影6例，肾功能明显改善。结论 腹腔镜肾盂成形术的成功关键在于正确的术前诊断、严格掌握其适应证与禁忌证，以及精确缜密的操作技术最大限度地保留病肾。
Abstract:
Objective To evaluate the clinical application value of retroperitoneal laparoscopic pyeloplasty. Methods 52 cases of laparoscopic pyeloplasty were retrospectively analyzed. The clinical experience and the latest scientific research at home and abroad and the surgical methodology, etiology, indications, contraindications and cautions combined with relevant literature review after the clinical course was summarized. The 52 cases included 35 males and 17 females. Age was from 9 to 44 years and mean was 16 years. 37 cases were on the left, and 15 cases were on right. Hydronephrosis expansion with small than 15 mm (mild) was showed by B-supersonic examination in 8 cases, 15 to 30 mm (moderate) in 33 cases, and more than 30 mm 11 cases. 34 cases developed well in 30 min with a IVU examination, 13 cases had light imaging in 30 to 120 min, and 5 cases undeveloped in 120 min. Results 52 cases were successfully operated. Operative time was 130 to 250 min, and the average was 162 min. The volume of blood loss was 35 to 110 ml, and average was 65 ml. The postoperative hospital stay was 5 to 8 days, and average was 7 days. 52 cases were postoperatively followed-up for 3 to 15 months. IVU showed no postoperative UPJ obstruction. 46 patients with good imaging after 30 min, weak imaging developed after 30 to 120 min in 6 cases. The renal function improved significantly. Conclusion The key points to the success of laparoscopic pyeloplasty include correct preoperative diagnosis, strict control of their indications, contraindications, the precise operative technique, and to maximize the reservation of unhealthily renal.

参考文献/References:

[1]Cheema IA, Manecksha RP, Flynn R. Laparoscopic pyeloplasty ［J］. Ir Med J， 2010,103(1):24-26.
[2］Srivastava A, Singh P, Maheshwari R， et al. Laparoscopic pyeloplasty: a versatile alternative to open pyeloplasty［J］.Urol Int， 2009，83(4):420-424.
[3］Oreilly PH,Brooman PJ,Mak S,et al. The long-term results of Anderson-Hynes pyeloplasty ［J］.BJU Int， 2001, 87(4):287-289.
[4］Ben Slama MR,Salomon L,Hoznek A,et al.Extraperitoneal laparoscopic repair of ureteropelvie junction obstruction:initial experience in 15 cases ［J］. Urology， 2000,56(1):45-48.
[5］Pouliot F, Lebel MH, Audet JF，et al.Determination of success by objective scintigraphic criteria after laparoscopic pyeloplasty ［J］. J Endourol， 2010，24(2):299-304.
[6］Gallo F, Schenone M, Giberti C.Ureteropelvic junction obstruction: which is the best treatment today? ［J］. J Laparoendosc Adv Surg Tech A， 2009,19(5):657-662.
[7］Wagner S, Greco F, Inferrera A， et al. Laparoscopic dismembered pyeloplasty: technique and results in 105 patients［J］. World J Urol， 2009, 22(1):28-30.
[8］Wang W,LeRoy AJ,McKusick MA,et al.Detection of crossing vessels as the cause of ureteropelvic junction obatraction:the role of antegrade pyelography prior to endopyelotomy［J］. J Vasc Interv Radiol, 2004,15(12):1435-1441.
[9］El-Nahas AR,Abou-El-Ghar M,Shoma AM,et al. Role of multiphasic helical computed tomography in planning surgical treatment for pelvi-ureteric junction obstruction［J］. BJU Int，2004,94(4):582-587.
[10］Moon DA,El-Shazly MA,Chang CM,et al.Laparoscopic pyeloplasty,evolution of a new gold standard［J］. Urology,2006,67(6):932-936.

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备注/Memo

备注/Memo:
江苏省“六大人才高峰“重点资助项目基金(2005A2)
更新日期/Last Update: 2010-07-20