摘要
目的评估腹腔镜或机器人肾盂瓣成形术治疗复杂上段输尿管狭窄的有效性及安全性。方法回顾性分析2020年2月至2022年8月在郑州大学第一附属医院行腹腔镜或机器人肾盂瓣成形术的复杂上段输尿管狭窄患者临床资料。所有患者术前均接受泌尿系超声、静脉尿路造影、CT尿路成像(CT urography,CTU)或磁共振尿路成像(MR urography,MRU)检查,必要时行逆行尿路造影或者会师造影,以明确肾积水程度、输尿管狭窄的位置及长度。记录并分析围术期参数及并发症发生情况,并对患者进行定期随访。结果本研究最终纳入12例患者,其中男10例、女2例,中位年龄34(15~67)岁。其中6例患者行腹腔镜肾盂瓣成形术,6例患者行机器人肾盂瓣成形术。手术均成功完成,无中转开放手术。两组患者术中测定的平均输尿管狭窄长度分别为5cm和4.1 cm,平均总手术时间分别为117 min和120 min,平均术中失血量分别为50 ml和56 ml,平均随访时间分别为18.5个月和26.7个月。腹腔镜组和机器人组患者手术成功率均为100%。结论腹腔镜或机器人肾盂瓣成形术治疗复杂上段输尿管狭窄手术成功率高、并发症少,疗效满意,为复杂上段输尿管狭窄的修复重建提供了借鉴经验。
Objective To evaluate the efficacy and safety of laparoscopic or robotic flap pyeloplasty in the treatment of complicated upper ureteral stricture.Methods The clinical data of patients undergoing laparoscopic or robotic flap pyeloplasty in the First Affiliated Hospital of Zhengzhou University from February 2020 to August 2022 were analyzed retrospectively.All patients underwent ultrasound,intravenous urography,CT urography(CTU)or MR urography(MRU)examination before operation.If necessary,retrograde urography or realignment angiography was performed to clarify the degree of hydronephrosis,location and length of ureteral stricture.The perioperative parameters and complications were recorded and analyzed,and the patients were followed up regularly.Results A total of 12patients were included in this study,including 10 males and 2 females,with a median age of 34years(15-67)years.Six patients underwent laparoscopic flap pyeloplasty,and six patients underwent robotic flap pyeloplasty.All operations were successfully completed,and there was no conversion to open surgery.The average length of ureteral stricture measured during operation was 5 cm and 4.1cm,the average total operation time was 117 min and 120 min,the average intraoperative blood loss was 50 ml and 56 ml,and the average follow-up time was 18.5 months and 26.7 months,respectively.The success rate of laparoscopic group and robotic group were both 100%.Conclusion Laparoscopic or robotic pyeloplasty for the treatment of complicated upper ureteral stricture has a high success rate,fewer complications,and satisfactory results,which provides a reference experience for the repair and reconstruction of complicated upper ureteral stricture.
作者
朱照伟
赵品
王声政
李鹏
陶金
范雅峰
于栓宝
詹永豪
张雪培
Zhu Zhaowei;Zhao Pin;Wang Shengzheng;Li Peng;Tao Jin;Fan Yafeng;Yu Shuanbao;Zhan Yonghao;Zhang Xuepei(Department of Urology,First Affiliated Hospital of Zhengzhou University,Zhengxhou,Henan 450052)
出处
《泌尿外科杂志（电子版）》
2023年第1期29-33,共5页
Journal of Urology for Clinicians(Electronic Version)
基金
河南省医学科技攻关计划省部共建重点项目(SBGJ202102140)
关键词
肾积水
输尿管狭窄
腹腔镜手术
机器人手术
肾盂瓣成形术
Hydronephrosis
Ureteral stricture
Laparoscopic surgery
Robotic surgery
Flap pyeloplasty
作者简介
通信作者:张雪培,E-mail:zhangxuepei@263.net
