摘要
目的:探讨腹腔镜手术治疗钬激光碎石术后中上段输尿管闭锁的方法和疗效。方法:回顾性分析2015年6月至2021年7月我院收治的输尿管镜钬激光碎石术后输尿管中上段闭锁患者16例,根据闭锁段位置、长度、体重指数等综合因素选择经后腹腔或经腹腔入路行腹腔镜输尿管闭锁段切除+输尿管端端吻合术。结果:本组16例均顺利完成手术,9例输尿管上段闭锁,7例中段闭锁;闭锁段长度0.5~4.2(1.8±0.8)cm。手术时间80~220(110±40.5)min;出血量50~220(70±50.5)ml;引流管留置时间7~10(8.0±0.8)d。随访7~48个月,所有患者肾积水均减轻。2例患者术后出现吻合口狭窄,行球囊扩张术后好转。结论:腹腔镜输尿管闭锁段切除+端端吻合术是治疗钬激光碎石术后输尿管中上段闭锁的有效方法。
Objective:To explore the method and effect of laparoscopic operation for the treatment of patients with upper or middle ureteral atresia following ureteroscopic lithotripsy with holmium laser.Methods:Total of 16 patientssuffering from upper or middle ureteral atresia after holmium laser lithotripsy from June 2015 to July 2021 were retrospective analysed at our institution.They were performed laparoscopic resection of the segments of ureteral atresia combined with ureteral anastomosis via transperitoneal or retroperitoneal approach,which was chosen according to multiple factors such as the position and length of ureteral atresia,the body mass index,etc.Results:All patients were finished the surgery successfully without serious complications including 9 patients with upper-segment atresia and 7 with middle-segment atresia with length ranging from 0.5-4.2(1.8±0.8)cm.The surgical duration was 80-220(110±40.5)min;the hemorrhagic volume was 50-220(70±50.5)ml;indwelling time of the drainage tube was 7-10(8.0±0.8)d.At a follow-up of 7-48 months,all patients experienced a reduction in hydronephrosis.Two patients developed postoperative anastomotic stricture,which improved after balloon dilation.Conclusion:Laparoscopic ureteral atresia resection combined with ureteral anastomosis is an effective method for the treatment of the upper or middle ureteral atresias related to holmium laser lithotripsy.
作者
刘河漾
庞月文
时京
段珺耀
巩会杰
闫永吉
Liu Heyang;Pang Yuewen;Shi Jing;Duan Junyao;Gong Huijie;Yan Yongji(Department of Urology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《微创泌尿外科杂志》
2022年第6期392-395,共4页
Journal of Minimally Invasive Urology
关键词
输尿管
钬
结石
腹腔镜
ureter
holmium
calculus
laparoscopy
作者简介
通信作者:闫永吉,7577yyj@163.com
