腹腔镜下悬吊治疗血管外压所致的肾盂输尿管连接部梗阻

doi:10.3877/cma.j.issn.1674-3253.2019.03.015

中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 203 -206. doi: 10.3877/cma.j.issn.1674-3253.2019.03.015

所属专题：文献；

临床研究

腹腔镜下悬吊治疗血管外压所致的肾盂输尿管连接部梗阻

李瑞晓¹, 李雪莲², 王磊¹, 王娟英¹, 唐启胜¹^,^†(

)

^1. 710038　西安，空军军医大学第二附属医院泌尿外科
^2. 710002　西安市中医医院外科

收稿日期:2018-07-13 出版日期:2019-06-01
通信作者: 唐启胜

Retrospective analysis of laparoscopic vascular hitching ureteropelvic junction obstruction induced by extrinsic vessel compression

Ruixiao Li¹, Xuelian Li², Lei Wang¹, Juanyin Wang¹, Qisheng Tang¹^,^†()

^1. Department of Urology, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
^2. Department of surgery, Xi'an Hospital of Traditional Chineses Medicine, Xi'an 710002, China

Received:2018-07-13 Published:2019-06-01
Corresponding author: Qisheng Tang
About author:
Corresponding author: Tang Qisheng, Email:tanglefoot@163.com

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目的

探讨血管外压致肾盂输尿管连接部梗阻（UPJO）患者行腹腔镜下血管悬吊不离断肾盂的可行性及疗效分析。

方法

收集我院2014年至2017年经影像学诊断为UPJO的患者，并筛选出因血管外压所致UPJO患者13例；对上述患者行腹腔镜下外压血管悬吊法治疗；术中严格进行利尿实验，确保无输尿管腔内狭窄，对该类患者进行回顾性分析研究。

结果

手术时间约65~125 min，平均95 min；术中平均出血量40 ml，手术的成功率为100%，术中均行利尿实验，排除管腔内狭窄后行腹腔镜下外压血管悬吊术，13例均未转开放。7例伴有腰腹部疼痛患者在术后3个月内不适均消失；术后3个月行肾脏CT检查发现13例患者肾积水较前均出现不同程度缓解；术后6个月复查CT肾积水较前缓解；并且进行利尿试验，患肾积水无加重。

结论

对于血管外压所致UPJO的患者，术中明确无管腔内狭窄后行腹腔镜下血管悬吊术，术后随访疗效确切。

关键词: 肾盂输尿管连接部梗阻（UPJO）, 腹腔镜, 血管外压, 悬吊

Objective

To evaluate the value and experience of laparoscopic vascular hitching procedure treatment of ureteropelvic junction obstruction (UPJO) induce by extrinsic vessel compression.

Methods

Patients diagnosed as UPJO in our hospital from 2014 to 2017, the data of 13 patients with UPJO due to extrinsic vessel treated with laparoscopic vascular hitching procedure were retrospectively analyzed.

Results

The operations were successfully performed in all patients. The operative time was 65-125 min. The mean blood loss was 40 ml. Diuretic experiments were performed during the operation. All 13 cases had not been switched to open surgery. Seven patients with lumbar and abdominal pain all disappeared 3 months later. CT examination at 3 months later revealed that hydronephrosis was improved; After 6 months,the hydronephrosis was relieved. And a diuretic test was conducted, the hydronephrosis did not worsen.

Conclusions

For patients with UPJO caused by extrinsic vessel compression, laparoscopic vascular hitching procedure was effective.

Key words: UPJO, Laparoscopy, Extrinsic vessel compression, Hitching

图2 肾积水及连接部迷走血管影像学表现（箭头所示为压迫血管）

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Retrospective analysis of laparoscopic vascular hitching ureteropelvic junction obstruction induced by extrinsic vessel compression

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Retrospective analysis of laparoscopic vascular hitching ureteropelvic junction obstruction induced by extrinsic vessel compression