Peng Qianlong,Zhao Yaowang,Tian Wen,et al.Laparoscopic combined ureteroscopic treatment of renal pelvis ureter obstruction: Analysis of the curative effect of complicated kidney stone[J].Journal of Clinical Pediatric Surgery,,19():694-698.[doi:10.3969/j.issn.1671-6353.2020.08.007]
Laparoscopic combined ureteroscopic treatment of renal pelvis ureter obstruction: Analysis of the curative effect of complicated kidney stone
- Keywords:
- Kidney Calculi/SU; Ureteral Obstruction/SU; Laparoscopes; Ureteroscopes; Child
- CLC:
- R692.4;R691.2;R726.1
- Abstract:
- Objective To explore the safety and efficacy of laparoscopy plus soft ureteroscopy for renal pelvic and ureteropelvic junction obstruction(UPJO) with renal calculi. Methods From March 2016 to March 2020, clinical data were retrospectively analyzed for 13 cases of UPJO with renal calculi. There were pyelithiasis with multiple calyceal calculi (n=5) and multiple calyx calculi. The involved side was left (n=9) and right (n=4). The stone diameter was 0.3-0.9 cm. Preoperative diagnosis was made by ultrasound type B and computed tomography (CT). All operations were performed through a three-hole transperitoneal approach. Laparoscopy for hydronephrosis proceeded routinely by making a small incision near ureter of renal pelvis after exposing dilated renal pelvis. Laparoscopic Trocar of ureteroscopy and lithotripsy were performed. Finally ureteropelvic anastomosis was performed under laparoscopy. Operative duration, stone clearance rate, postoperative complications and operative outcomes were recorded. Color Doppler ultrasound and CT were employed for postoperative follow-ups. Results Complete removal of stones and complete rupture of ureteropelvic and renal pelvis have been performed without a transit open surgery. The operative duration was 90-118 min and the volume of blood loss 3-30 ml. There was no blood transfusion. A liquid diet resumed at Day 2 post-operation. The average postoperative hospital stay was 6(5-7) days. During an average follow-up period of 12(8-18) months, there were no serious postoperative complications. No residual stone was found. Hydronephrosis subsided obviously and even disappeared. Conclusion For UPJO with kidney stones without affecting the operative outcomes of hydronephrosis, laparoscopy plus ureteroscopy may significantly boost stone clearance rate. With minimal surgical trauma, it is safe, convenient and efficacious with a quick recovery.
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Memo
收稿日期:2020-06-10。
基金项目:湖南省出生缺陷协同防治科技重大专项（编号：2019SK1010）
通讯作者:赵夭望,Email:yw508@sina.com