[1]黄轶晨,谢华,吕逸清,等.机器人辅助腹腔镜下Lich-Greqoir手术治疗儿童原发性膀胱输尿管反流[J].临床小儿外科杂志,2020,19(02):150-154.[doi:10.3969/j.issn.1671-6353.2020.02.012]
　Huang Yichen,Xie Hua,Lv Yiqing,et al.Preliminary experience of robotic assisted laparoscopic ureteral reimplantation in children with primary vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,2020,19(02):150-154.[doi:10.3969/j.issn.1671-6353.2020.02.012]
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机器人辅助腹腔镜下Lich-Greqoir手术治疗儿童原发性膀胱输尿管反流

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第19卷 期数: 2020年02期 页码: 150-154 栏目: 论著 出版日期: 2020-02-20
Title:
Preliminary experience of robotic assisted laparoscopic ureteral reimplantation in children with primary vesicoureteral reflux
作者:
黄轶晨1;  谢华1;  吕逸清1;  陈艳1;  李晓溪1;  孙会振1;  周立军1;  梁龑1;  陈方1; 2
1. 上海市儿童医院, 上海交通大学附属儿童医院泌尿外科(上海市, 200062);
2. 上海交通大学附属第六人民医院 (上海市, 200233)
Author(s):
Huang Yichen1;  Xie Hua1;  Lv Yiqing1;  Chen Yan1;  Li Xiaoxi1;  Sun Huizhen1;  Zhou Lijun1;  Liang Yan1;  Chen Fang1; 2
1. Department of Urology, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai 200053, China;
2. Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
关键词:
机器人; 腹腔镜检查; 膀胱输尿管反流/外科学; 输尿管疾病/外科学; 儿童
Keywords:
Robotics; Laparoscopy; Vesico-Ureteral Reflux/SU; Ureteral Diseases/SU; Child
分类号:
R726.1;R693+.2
DOI:
10.3969/j.issn.1671-6353.2020.02.012
摘要:
目的 探讨机器人辅助腹腔镜下Lich-Greqoir手术治疗儿童原发性膀胱输尿管反流的可行性、安全性和手术技巧。方法 回顾性分析2014年5月至2019年2月上海市儿童医院收治的11例原发性膀胱输尿管反流患儿临床资料，其中男童10例，女童1例，均应用达芬奇系统辅助腹腔镜行Lich-Greqoir输尿管再植手术。患儿平均年龄9.4岁（3.2~18岁）。其中双侧4例，单侧7例。反流程度Ⅱ~Ⅳ级（Ⅱ级2侧，Ⅲ级3侧，Ⅳ级10侧）。结果 患儿均采用Lich-Gregoir术式，术中患侧输尿管平均直径9 mm（5~15 mm），平均黏膜下隧道长度4.4 cm（3~6 cm）。术中无中转开放手术，单侧输尿管手术平均时间152 min（132~175 min），双侧输尿管手术平均时间257 min（249~264 min），术后平均住院时间4.5 d（3~6 d），1例双侧VUR患儿术后出现短期尿潴留，延长留置导尿管2周后痊愈。患儿平均随访时间2.5年（6个月至5.3年），所有病例均无发热性尿路感染，B超均未见患侧输尿管肾盂积水加重。术后完成VCUG 9例（其中双侧4例，单侧5例），其中1例双侧病例术后发现左侧反流Ⅰ级。结论 机器人辅助腹腔镜下Lich-Greqoir手术治疗儿童原发性膀胱输尿管反流安全、有效，可以应用于3岁以上儿童的治疗。
Abstract:
Objective To summarize our preliminary surgical experiences and short-term outcomes of robotic assisted laparoscopic ureteral reimplantation (RALUR) in children with primary vesicoureteral reflux.Methods From May 2014 to February 2019,the clinical data of children undergoing RALUR Lich-Greqoir were retrospectively analyzed.There were 10 boys and 1 girl with an average age of 9.4(3.2-18) years.The involved side was bilateral (n=4) and unilateral (n=7).The degrees of vesicoureteral reflux (VUR) were grade Ⅱ-Ⅳ.Results All cases underwent Lich-Gregoir procedure.The average operative durations were 152(132-175) min for unilateral cases and 257(249-264) min for bilateral cases.The average postoperative hospital stay was 4.5(3-6) days.During an average follow-up period of 2.5(0.5-5.3) years,none had any febrile urinary infection.Ultrasound showed decreased hydronephrosis.And 9/11 cases (4/4 bilateral cases and 5/7 unilateral cases) completed voiding cystourethrogram.There was one recurrent bilateral case.Conclusion RALUR is both safe and effective for repairing VUR in children aged >3 years.

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备注/Memo

收稿日期:2019-09-26。
基金项目:上海市级医院新兴前沿技术联合攻关项目（编号：SHDC12010108）
通讯作者:谢华,Emai:drxiehua@163.com

更新日期/Last Update: 1900-01-01