论文部分内容阅读
目的观察后腹腔镜下行离断性肾盂成形术治疗小儿肾盂输尿管连接部(UPJ)梗阻的临床疗效。方法采用经腹膜后径路施行腹腔镜下离断性肾盂成形术治疗小儿UPJ梗阻17例,年龄3～10岁。所有患儿均经影像学检查诊断UPJ梗阻,15例有腰部胀痛或泌尿系统感染史、患侧腹部触及肿块,2例有肾功能减退。结果17例UPJ梗阻患儿均取得满意的临床疗效。手术时间2．5～6．0 h,平均4．3 h,随着经验增加,手术时间缩短。平均出血量38 ml,平均术后住院时间4．6 d。1例发生术后尿漏。随访6～24个月,平均14个月,UPJ梗阻的症状均消失,影像学检查无梗阻。结论后腹腔镜下离断性肾盂成形术是治疗小儿UPJ梗阻安全、有效的方法,可以替代开放性手术。
Objective To observe the clinical effect of retroperitoneal laparoscopic subdural pyeloplasty in the treatment of pediatric ureteropelvic junction obstruction. Methods 17 cases of pediatric UPJ obstruction were treated by retroperitoneal laparoscopic rupture of pyeloplasty, aged 3 to 10 years. All children underwent imaging diagnosis of UPJ obstruction, 15 cases of lumbar pain or urinary tract infection, ipsilateral abdominal touching lumps, 2 cases of renal dysfunction. Results 17 cases of children with UPJ obstruction have achieved satisfactory clinical efficacy. The operation time was 2.5-6.0 hours, with an average of 4.3 hours. As the experience increased, the operation time was shortened. The average amount of bleeding 38 ml, the average postoperative hospital stay 4.6 d. One patient had postoperative urinary leakage. All cases were followed up for 6 to 24 months, with an average of 14 months. The symptoms of UPJ obstruction disappeared and no obstruction was found in the imaging examination. Conclusion Retroperitoneal laparoscopic pyeloplasty is a safe and effective method for the treatment of pediatric UPJ obstruction. It can replace open surgery.