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经腹腹腔镜半肾输尿管切除术治疗成人重复肾畸形(附5例报告)
肖成武,花梅免,杨庆*
0
(海军军医大学(第二军医大学)长海医院泌尿外科, 上海 200433
*通信作者)
摘要:
目的:探讨经腹腹腔镜治疗成人重复肾畸形的手术技巧及效果。 方法:2015-2018年单中心单术者完成成人重复肾畸形患者5例,所有患者均行泌尿系统增强CTU确诊为重复肾。回顾性分析患者的临床资料,包括手术技巧,手术时间,术中出血量,肠道功能恢复时间,住院天数等临床资料。 结果:5例患者均顺利完成手术,手术时间为152±32.7min(110-200min),出血量 106±83ml(50-250ml),术后肠道恢复时间2±1.1天(1-3)天,住院天数7±1.1天(5-8天)。术后随访6-32个月,复查B超、肾功能提示残存肾脏正常。 结论:经腹腹腔镜下重复肾切除技术安全可靠,肾门血管的解剖是保护术后肾脏功能的关键,肾盂粘膜的完整切除是预防尿性囊肿复发的关键。
关键词:  经腹腔  腹腔镜检查  重复肾  半肾切除术
DOI:10.16781/j.0258-879x.2019.11.1277
投稿时间:2019-05-18修订日期:2019-06-23
基金项目:
Transperitoneal laparoscopic heminephroureterectomy for adult duplex kidneys: a report of 5 cases
XIAO Cheng-wu,HUA Mei-mian,YANG Qing*
(Department of Urology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Object:To evaluated the surgical skill and safy of laparoscopic heminephrectomy in patients with duplex kidneys. Methods: From 2015 to 2018, five unilateral laparoscopic heminephrectomy were performed by single surgeon in our center. All patients were diagnosed as duplex kidney by enhanced CTU.Patients' characteristics, surgical skills, operative time, and blood loss, intestinal recovery time, length of hospital stay were all collected retrospectively. Results: All five patients were successful completed. Mean operative time was 152±32.7min(110-200min),intestinal recovery time was 2±1.1 days(1-3 day). Mean hospital stay was 7±1.1day(5-8 days). On mean follow-up of 6-32 months, B ultrasonography and renal function indicated that the residual kidney was normal. Conclusion: The technique of laparoscopic heminephrectomy with duplex kidneys is safe and reliable. Seperation of renal hilum vessels is the key to protect the renal function. The key to prevent the recurrence of urinary cysts is complete removal of pelvic mucosa.
Key words:  transperitoneal  laparoscopy  duplex kidneys  heminephrectomy