摘要
目的探讨后腹腔镜下上半肾输尿管切除术治疗成人重复肾畸形的疗效。方法2008年1月-2012年12月对26例重复。肾畸形并积水的患者行后腹腔镜下上半肾输尿管切除术。记录所有患者的手术时间和术中出血量；观察患者术后早期恢复情况、并发症发生情况，以及评价手术疗效。结果26例患者均顺利完成后腹腔镜下上半肾输尿管切除术。手术时间100～210min，平均手术时间为（140．2±23．5）min；术中出血量40～130mL，平均术中出血量为（80．1±21．6）mL。所有患者均未输血，术中均无明显并发症发生，术后复查肾功能均未见明显改变。术后3d拔除导尿管并下床活动，当负压引流管中引流液量〈20mL后拔除引流管。术后住院时间6～8d，平均术后住院时间（6．8±0．7）d。1例患者术后发生尿漏，行选择性肾动脉栓塞后治愈。术后所有患者均获随访，随访时间6～18个月，平均随访时间为（11．3±5．6）个月；无1例患者有发热、腰酸和漏尿症状，复查B超均未发现’肾周积液，静脉尿路造影检查显示患者下半肾功能均正常。结论后腹腔镜下上半肾输尿管切除术是一种安全有效、创伤小、出血少、恢复快的微创治疗方法。
Objective To explore the clinical outcomes of retroperitoneoscopic upper pole partial nephrectomy for duplicated kidney in adult patients. Methods From January 2008 to December 2012, 26 patients with duplicated kidney and hydronephrosis underwent retroperitoneoscopic upper pole partial nephrectomy in our institution. The operation time, estimated blood loss, postoperative recovery, and complications were recorded to assess the operative effect. Results All procedures were successfully completed. The mean operation time was （ 140.2 ± 23.5） minutes （range from 100 to 210 min）. The mean intraoperative blood loss was （80.1 ± 21.6） mL （range from 40 to 130 mL）. No severe complications occurred during the surgery and quick recovery of renal function was obtained after the surgery. Urethral catheter was pulled out 3 days postoperatively. Drainage tube was pulled out when draining volume was less than 20 mL. The mean postoperative hospital stay was （6.8 ± 0.7） days （range from 6 to 8 days）. One case required selective embolization of renal artery for urinary fistula. During the follow up （[11.3 ± 5.61 months on average, range from 6 to 18 months）, no pyrexy, waist soreness or leakage of urine were noted. No signal for urinoma was identified by ultrasonograph. Urography showed that the renal function of lower pole was normal. Conclusion Retroperitoneoscopic upper pole partial nephrectomy is a safe, effective and minimally invasive technique for duplicated kidney in adult patients. There are less blood loss and quick postoperative recovery after surgery.
出处
《上海医学》
CAS
CSCD
北大核心
2014年第1期54-56,共3页
Shanghai Medical Journal
关键词
后腹腔镜
肾部分切除
重复肾
Retroperitoneoscopy Partial nephrectomy
Duplicated kidney
