摘要
目的:总结机器人下通过自体口腔颊黏膜移植治疗输尿管长段狭窄及其并发症的临床手术的相关经验,探讨此术式的临床疗效及其安全性。方法:2017年11月-2020年5月,利用Da Vinci手术机器人系统对4例输尿管长段狭窄伴肾积水患者施行机器人下自体口腔颊黏膜移植输尿管成型术。结果:4例均成功完成手术,狭窄段长度2.9(2.5~3.5)cm,手术持续时间236(210~260)min、术中累计出血量75(50~100)mL,术后引流管在2.75(2~3)d拔除,导尿管在8(7~10)d拔除,双J管通常在10~12周拔除,术后无并发症产生。术后在2~35个月进行随访,影像学复查包括肾脏超声及CT,4例患者肾积水情况均较术前显著减轻,肾小球滤过率ECT检查均较术前有所改善。结论:机器人下自体口腔颊黏膜移植输尿管成型术术后并发症少,是一种安全、有效的微创术式。
Objective:To describe the reconstruction of long ureteric strictures using buccal mucosal grafts and to assess the clinical efficacy and safety.Methods:From November 2017 to May 2020,we performed robotic-assisted ureteral reconstruction using buccal mucosa grafts in 3 patients with long ureteral stenosis and hydronephrosis.Results:All cases were performed successfully.In the 4 cases,the mean length of ureteric stricture was 2.9(2.5-3.5)cm,the mean operation time was 236 min(230-260 min),average blood loss was 75(50-100)mL,average extubation time was 2.75(2-3)days,average catheter removal time was 8(7-10)days and average double J stents removal time was 10-12 weeks.No postoperative complications occurred.All patients were followed up for 2-35 months.Radiological examination revealed that hydronephrosis and glomerular filtration rate were improved.Conclusion:Robotic buccal mucosa graft ureteroplasty is a feasible option for reconstruction of long ureteral strictures with less postoperative complications.
作者
沈天一
汤昊
张征宇
周文泉
薛松
周凯
李平
葛京平
SHEN Tianyi;TANG Hao;ZHANG Zhenyu;ZHOU Wenquan;XUE Song;ZHOU Kai;LI Ping;GE Jingping(Department of Urology,General Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China)
出处
《微创泌尿外科杂志》
2021年第4期217-220,共4页
Journal of Minimally Invasive Urology
关键词
输尿管狭窄
颊黏膜
达芬奇机器人辅助手术
重建术
ureteric stricture
buccal mucosa
Da Vinci robot-assisted surgery
reconstructive surgical procedure
作者简介
通讯作者:葛京平,GJP_doctor@qq.com
