摘要
目的探讨腹腔镜手术治疗重复肾双输尿管畸形的可行性和疗效。方法回顾性分析8例重复肾双输尿管畸形的临床资料。重复肾均位于肾上极，其中左侧5例，右侧3例，均为单侧。术前均经影像学确诊。4例行经后腹腔镜重复肾重复输尿管切除术，4例采用经腹腔途径完成手术。观察手术时间、术中出血量、术中术后并发症及手术效果，术后随访采用排泄性尿路造影（IVU）及彩超观察保留肾脏的功能情况。结果8例手术均获得成功，无中转开放手术。手术时间110-170min，平均142min；术中出血量10－100ml，平均20ml，无手术输血者。术后24～72h进流食，术后3～4天拔除引流管。术后住院时间7～8天，平均7．5天。8例术后随访3—24个月，平均12个月。术中术后均未发生严重并发症。随访3～24个月，1例因输尿管残端炎需要再次入院手术治疗。其余7例IVU和彩超显示下半正常肾功能良好，原发病的症状消失。结论腹腔镜手术治疗重复肾双输尿管畸形具有创伤小、并发症少、恢复快等优点，值得临床推广应用，术中应尽量彻底切除重复输尿管全程，防止残端感染等情况的发生，经腹入路具有一定优势。
Objectives Eight patients with urinary tract duplex anomalies underwent laparoscopic hemine- phrectomy using retroperitoneal or transperitoneal approach were retrospectively analyzed. Methods The sites of surgery of all cases were upper heminephrectomy, including 5 in the left and 3 in the right. All cases were dignosised with radiography. Four patients treated with retroperitoneal approach, while another 4 treated with transperitoneal approach. Follow - up studies were performed using renal ultrasonography and IVU in all patients. Results All patients underwent laparoscopic surgery successfully without conversion to open surgery or intraoperative complications. The mean operative time was 142 minutes （range 110 - 170min）. The mean estimated blood loss was 20 mL （range 10 - 100）, and the mean hospital stay was 7.5 days （range 7 -8）. During the follow -up of 3 -24 months, a urinary infection in the residual ureter stump occurred and was resolved with open surgery. No postoperative complications occurred in other 7 patients as confirmed by radiologic assessment. Conclusions Laparoscopic upper pole nephroureterectomy is a safe and effective procedure and an excellent minimally invasive treatment option for the adult patient with a duplex kidney. The distal upper pole ureter should be transected as far as possible to prevent the recurrence of urinary infection in the residual ureter stump.
出处
《国际泌尿系统杂志》
2012年第1期3-5,共3页
International Journal of Urology and Nephrology
关键词
肾
输尿管
外科手术
腹腔镜
Kidney
Ureter
Surgical Procedures, Laparoscopic
