腹腔镜下Anderson-Hynes肾盂成形术治疗婴儿肾盂输尿管连接处梗阻.docVIP

腹腔镜下Anderson-Hynes肾盂成形(） [摘要] 目的 评估腹腔镜下Anderson-Hynes肾盂成形术ureteropelvic junction obstruction,UPJO）的可行性、安全性、疗效和优势经腹腔入路腹腔镜下Anderson-Hynes肾盂成形术B超检测AP值变化，评价2组术后积水缓解情况及再次手术发生率。结果 48例中，1例（2.1%）因术中肠道扩张显露术野困难，被动中转开放。47例在腹腔镜下顺利完成离断式Anderson‐Hynes肾盂输尿管成形术。术中无与气腹相关的并发症，无肠道损伤及相关脏器损伤。11例（23.4％）并发症中7例（14.9％）为轻度Clavien 级，其中外引流组3例暂时性吻合口梗阻，1例引流管堵塞经冲洗后通畅；内引流组1例尿外渗持续引流后治愈，1例术后持续24h肉眼血尿经止血药物治疗后消失，1例大网膜经脐部穿刺孔脱出于皮下，经镇静后回纳入腹腔及包扎后治愈。另4例（8.5％）为Clavien级，均发生在内引流组，为尿路感染，经抗感染治愈Anderson-Hynes肾盂成形术治疗婴儿, He Dawei, Liu Xing, Hua Yi, Zhang Deying, Liu Junhong, Liu Feng, Lin Tao，Wei Guanghui （Department of Urology, Childrens Hospital of Chongqing Medical University, Chongqing 400014） [Abstract] Objective Laparoscopic pyeloplasty have demonstrated efficient and safe for the treatment of UPJ obstruction in older pediatric patients. But the role of laparoscopic pyeloplasty in infants is less well defined. We evaluate the feasibility, safety, efficiency and advantage of laparoscopic Anderson-Hynes pyeloplasty for the treatment of UPJ obstruction in children younger than 1 year of age. Methods We retrospectly reviewed all infants undergoing transperitoneal laparoscopic Anderson-Hynes pyeloplasty for UPJ obstruction from July 2008 to May 2013 in our hospital (n=48). During operation all were drained randomly with double-J sent and ureteral sent as two groups of internal drainage and external drainage on simple random sampling methods. The operative duration,intraoperative and postoperative complications, postoperative hospital stay,and rate of redo pyeloplasty were compared between the two groups.We followed the change of AP with ultrasound at regular intervals and analyzed the outcome of two groups postoperation. Results forty-seven infants completed transperitoneal laparoscopic Anderson-Hynes pyeloplasty except one case of intraoperative convertion to open surgery limited to abdominal working space because of intestine dilatation. Median operative time of twe groups has no significant differ