腹腔镜手术治疗肾盂输尿管连接部狭窄19例

目的 评价腹腔镜手术治疗肾盂输尿管连接部狭窄（ureteropelvic junctiono bstruction，UPJO）的疗效。方法 采用经腹路径对19例UPJO行离断式。肾盂输尿管成形术。打开侧腹膜，以。肾下极为标志游离出。肾盂输尿管连接部，切除狭窄部分，端端吻合肾盂输尿管并留置双J管。结果 19例手术全部成功，手术时间110～240min，平均150min。术中出血量50～100ml，平均80ml，无严重并发症发生。术后住院6～10d，平均7．8d。19例随访3～15个月，平均6个月，14例静脉尿路造影（intrarenous urography，IVU）无吻合口狭窄。结论 腹腔镜下离断式肾盂输尿管成形术治疗UPJO有效、可行，可以替代开放手术。

Laparoscopic treatment of ureteropelvic junction obstruction

Objective To evaluate the clinical efficiency of laparoscopic operation for the treatment of ureteropelvic junction obstruction(UPJO).Methods A total of 19 patients with UPJO underwent laparoscopic dismembered pyeloplasty.The operation was performed under general anesthesia.The patients were maintained in a lateral decubitus on unaffected side.After the establishment of pneumoperitoneum,3~4 trocars were introduced at proper sites.During the operation,the lateral peritoneum was opened and the ureteropelvic junction obstruction was dissociated and dissected.The end-to-end anastomosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter.Results All the operations were performed successfully.The operation time was 110~240 min(mean,150 min),the blood loss was 50~100 ml(mean,80 ml),and the postoperative hospitalization time,6~10 d(mean,7.8 d).No severe complications occurred.Follow-up assessment with intravenous urography for 3~15 months(mean,6 months) in 14 patients showed no ureteral stricture.Conclusions Laparoscopic dismembered pyeloplasty is an effective and safe procedure in the treatment of UPJO.It can replace the open surgery.