Qin Daorui,Tang Yunman,Mao Yu,et al.The applied study of “ureter pulls out technique” in laparoscopic dismembered AndersonHynes pyeloplasty:a preliminary report.[J].Journal of Clinical Pediatric Surgery,2018,17(03):219-222.
“ 输尿管拖出法” 在腹腔镜离断式肾盂成形术中的应用
- Title:
- The applied study of “ureter pulls out technique” in laparoscopic dismembered AndersonHynes pyeloplasty:a preliminary report.
- Keywords:
- Ureter; Hydronephrosis; Surgical Procedures; Operative; Laparoscopes
- 文献标志码:
- A
- 摘要:
-
目的 探讨“输尿管拖出法”在腹腔镜离断式肾盂成形术治疗小儿肾盂输尿管连接部梗
阻中的手术技巧，总结该方法的临床应用价值。 方法 回顾性分析２０１５ 年１１ 月至２０１６ 年５ 月本院
收治的１５ 例肾盂输尿管连接部梗阻患儿临床资料，其中男性８ 例，女性７ 例，年龄２ 个月至８ 岁。因胎
儿期发现肾积水出生后随访积水进行性加重８ 例，因腹痛就诊行超声检查发现肾积水７ 例。患儿均接
受腹腔镜下离断式肾盂成形术，术中采用输尿管拖出法处理病变段。收集手术情况、手术时间、出血量
及并发症情况。术后定期门诊超声随访。 结果 １５ 例均手术成功，无中转开放手术病例，无留置Ｊ 管
相关并发症。平均手术时间１４３（１１６ ～２４４）ｍｉｎ。平均术中出血量５（２ ～１５） ｍＬ。术中留置双Ｊ 管耗时平
均６（３ ～１０）ｍｉｎ。术中留置双Ｊ 管困难，发现输尿管远端狭窄１ 例。术后平均住院时间７（５ ～１０） ｄ。术后
１ 个月复查超声，提示肾盂积水较术前明显减轻，肾实质厚度稳定。 结论 在腹腔镜治疗肾盂输尿管
连接部梗阻中采用“输尿管拖出法”处理输尿管，并留置双Ｊ 管安全可行，有精确触觉反馈，能够提高肾
盂输尿管连接部梗阻合并输尿管中、远段病变的检出率，降低手术初学者难度，值得临床推广。
- Abstract:
- ObjectiveTo evaluate the experience and result of the “ureter pulls out technique” in laparoscopic dismembered AndersonHynes pyeloplasty.Methods15 patients (8 males and 7 females) were retrospectively reviewed between November 2015 and May 2016，who had been diagnosed with hydronephrosis and received laparoscopic dismembered AndersonHynes pyeloplasty.The operations were carried out under general anaesthesia. During the operation，the “ureter pulls out technique” was employed.The clinical data was recorded，including time consuming，blood lose，length of hospital stay after operation and complication.ResultsAll 15 patients received laparoscopic ureteropyeloplasty，and “ureter pulls out techniques” were employed during operations. All operations went smoothly without conversion record. Average time consuming:143min (range 116~244 min).Blood lose:5 mL(range 2~15 mL). A UVJO case was recorded for the unsuccessful seat of “double J” stent during operation.Average hospital stay length was 7 d (range 5~10 d). Ultrasonography study demonstrated a significantly relieve of hydronephrosis after operation for one month.ConclusionThe “ureter pulls out technique” is safe and feasible in laparoscopic dismembered AndersonHynes pyeloplasty. The accurate haptic feedback can improve the positive detective ratio of the ureter distal lesion; also improve the accuracy of treating UPJ，reducing the difficulty for beginners. It is worthy of clinical application.
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