摘要
目的探讨腹腔镜游离性输尿管膀胱再植术的适应证、手术方法、临床疗效。方法采用腹腔镜游离性输尿管膀胱再植术治疗输尿管末端梗阻36例患者,其中左侧20例,右侧14例,双侧2例。26例为输尿管末端狭窄,其中6例合并输尿管结石、2例合并输尿管末端肿瘤,1例左肾结核并双肾积水,10例为巨输尿管。结果 36例手术均获得成功。手术时间60～180 min,平均100 min;术中出血30～120 ml,平均60 ml;住院3～14 d,平均7 d。患者术后恢复期均无并发吻合口瘘或肾积水加重。36例患者均于术后3～6个月内行B超以及静脉肾盂造影检查,15例肾输尿管积水消失,21例好转。行膀胱造影检查者,未见有输尿管返流发生。结论腹腔镜游离性输尿管膀胱再植术创伤小,抗反流效果明确,尿瘘、吻合口梗阻等并发症少,在治疗输尿管梗阻中,具有良好的效果。
Objective To introduce a new technique of laparoscopic ureteroneocystostomy and to evaluate its feasibility,safety and efficacy.Methods 36 cases underwent laparoscopic ureteroneocystostomy due to distal ureter obstruction.In these cases,20 cases were in the left,14 in right and 2 in bilateral.26 cases were diagnosed as ureter orifice stricture,in which 6 cases combined with ureter calculi and 6 cases with distal ureteral tumor.1 case had renal tuberculosis in left and bilateral hydronephrosis.The other 10 cases were diagnosed as congenital megaureter. Results All the operations were successful.The operation time was 60～180 min(mean 100 min) and the blood loss was 30～120ml(mean 60ml).The patients were discharged 3～14 days(mean 7 d),without urine leakage or hydronephrosis aggravated.Within 3～6 months postoperatively,the Beta -ultrasound and IVU showed the decreased hydronephrosis in 21 cases(mild),and complete disappearance of hydronephrosis in 15 cases.The cystography showed no urine vesicoureteral reflux in all cases.Conclusions The new technique of laparacopic ureteroneocystostomy was a minimal invasive procedure with clear view,less complications and excellent anti - vesicoureteral reflux effect.It would play an important role in the treatment for distal ureteral obstruction.
出处
《泌尿外科杂志（电子版）》
2009年第1期4-6,共3页
Journal of Urology for Clinicians(Electronic Version)
关键词
腹腔镜手术
输尿管膀胱再植术
laparoscopic surgery
Laparacopic ureteroneocystostomy
