腹腔镜肾盂成形术中联合输尿管镜取石术

Transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope

摘要:

目的 评价腹腔镜肾盂成形术中联合输尿管镜取石术的可行性及临床价值。方法 采用经腹途径施行腹腔镜离断式肾盂成形术联合输尿管镜取石术治疗输尿管肾盂连接部梗阻（UPJO）合并肾盏结石9例。男7例，女2例。重度积水6例，中度积水3例，上盏结石3例，中盏结石4例，下盏结石2例。结果 9例手术均获成功。手术时间120～200 min，平均140 min；出血量40～150 mL，平均70 mL。术后住院时间7～10 d，平均8.2 d。术后无漏尿，无结石残留。随访6～12个月，UPJ吻合口无狭窄，肾积水减轻，其中，中度积水2例，轻度5例，肾积水消失2例。肾功能均有明显改善。结论 经腹途径施行腹腔镜肾盂成形术中联合输尿管镜取石术疗效确切，有一定临床应用价值。

Abstract:

【Objective】 To evaluate the feasibility and clinical value of transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope. 【Methods】 Of the 9 cases of ureteropelvic junction (UPJ) obstruction and renal calyx caliceal stones who underwent transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope. 7 males and 2 females, of whom 6 had severe hydronephrosis; 3 intermediate. Upper renal calyx caliceal stones 3 cases, middle 5 and lower 2. 【Results】 The operation was successful in all cases, operative time was 120~200 min , with an average of 140min, blood loss was 40~150 mL, with an average of 70 mL, hospital stay was 7~10 d, with an average of 8.2 d, there was no urine leakage and residual stones of all cases. Follow-up of 6~12 months showed there was no stricture at UPJ and hydronephrosis was remitted (intermediate hydrops in 2 cases, mild in 5 and resolution in 2). The renal functions were distinctly improved. 【Conclusion】 Transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope was effective, and deserved further clinical application.