Tao Tian,Zhang Xiaowei,Zhao Yang,et al.Preliminary application of robotic-assisted laparoscopic colon Yang-Monti-Huixia procedure for the repair of long-segment Ureteral Strictures[J].Journal of Clinical Pediatric Surgery,2025,(06):548-552.[doi:10.3760/cma.j.cn101785-202503117-008]
机器人辅助腹腔镜结肠Yang-Monti-Huixia术修复输尿管长段狭窄的初步应用
- Title:
- Preliminary application of robotic-assisted laparoscopic colon Yang-Monti-Huixia procedure for the repair of long-segment Ureteral Strictures
- 摘要:
- 目的 评估机器人辅助腹腔镜下结肠Yang-Monti-Huixia术修复输尿管长段狭窄的安全性和短中期疗效。方法 回顾性分析2022年4月至2024年3月在解放军总医院第七医学中心儿童泌尿外科接受机器人辅助腹腔镜下结肠Yang-Monti-Huixia术的3例输尿管长段狭窄患儿临床资料。3例术前均经泌尿系超声、磁共振尿路造影、利尿性肾动态显像等检查明确诊断。评估术后梗阻解除及肾功能恢复情况。结果 3例患儿中,男2例、女1例,均为左侧输尿管狭窄,平均年龄9.3岁。均在机器人辅助腹腔镜下完成手术,无一例中转开放手术,无一例术中及术后严重并发症。平均肾盂及输尿管缺损长度7.7 cm,平均手术时间205 min,术中平均出血量33.3 mL,术后平均引流管留置时间7 d,术后平均住院时间14 d。平均随访时间22个月,术后2个月输尿管镜探查均显示吻合口通畅,未见黏液及结石形成;术后6个月利尿性肾动态显像提示梗阻均解除,分肾功能改善,疗效满意。结论 机器人辅助腹腔镜下结肠Yang-Monti-Huixia术修复输尿管长段狭窄安全可行,短中期疗效满意。
- Abstract:
- Objective To evaluate the safety and short- to mid-term outcomes of robotic-assisted laparoscopic colon Yang-Monti-Huixia procedure for the repair of long-segment ureteral strictures. Methods A retrospective analysis was conducted on the clinical data of 3 pediatric patients with long-segment ureteral stricture who underwent robotic-assisted laparoscopic colon Yang-Monti-Huixia procedure at the Department of Urology,The Seventh Medical Center,PLA General Hospital,between April 2022 and March 2024.Preoperative evaluations included urinary tract ultrasound,magnetic resonance urography,and diuretic renal dynamic imaging to confirm the diagnosis.Postoperative assessments focused on obstruction resolution and renal function recovery. Results Of the 3 patients,2 were male and 1 female,all with left-sided ureteral stricture.The mean age was 9.3 years.All procedures were completed robotically without conversion to open surgery or occurrence of severe intraoperative/postoperative complications.The average length of renal pelvis and ureteral defect was 7.7 cm.The mean operative time was 205 minutes,average intraoperative blood loss was 33.3 mL,mean postoperative drain duration was 7 days,and mean hospital stay was 14 days.At a mean follow-up of 22 months,ureteroscopic examination at 2 months post-op showed patent anastomoses without mucus or stone formation.Diuretic renal dynamic imaging at 6 months post-op showed resolution of obstruction and improved split renal function,indicating satisfactory outcomes. Conclusions Robotic-assisted laparoscopic colon Yang-Monti-Huixia procedure is a safe and feasible method for repairing long-segment ureteral strictures in children,with favorable short-to mid-term efficacy.
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备注/Memo
收稿日期:2025-3-25。
基金项目:军队计生专项(24JSZ13);首都医学发展科研专项(2022-02-5083)
通讯作者:周辉霞,Email:huixia99999@163.com