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中华腔镜泌尿外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (01) : 47 -52. doi: 10.3877/cma.j.issn.1674-3253.2025.01.009

临床研究

输尿管脱套技术在腹腔镜无功能重度积水重复上位半肾切除术中的应用
叶照华1, 李志雄1, 罗杰鑫1, 刘绍虔1, 李牧1, 米其武1,()   
  1. 1.523109 广东,东莞市人民医院泌尿外科
  • 收稿日期:2023-03-20 出版日期:2025-02-01
  • 通信作者: 米其武

The application of ureteral degloving technique in laparoscopic non-functional severe hydronephrosis duplicated upper pole heminephrectomy

Zhaohua Ye1, Zhixiong Li1, Jiexin Luo1, Shaoqian Liu1, Mu Li1, Qiwu Mi1,()   

  1. 1.Department of Urology, Dongguan People's Hospital, 523109 Guangdong, China
  • Received:2023-03-20 Published:2025-02-01
  • Corresponding author: Qiwu Mi
引用本文:

叶照华, 李志雄, 罗杰鑫, 刘绍虔, 李牧, 米其武. 输尿管脱套技术在腹腔镜无功能重度积水重复上位半肾切除术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 47-52.

Zhaohua Ye, Zhixiong Li, Jiexin Luo, Shaoqian Liu, Mu Li, Qiwu Mi. The application of ureteral degloving technique in laparoscopic non-functional severe hydronephrosis duplicated upper pole heminephrectomy[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(01): 47-52.

目的

探讨输尿管脱套技术在腹腔镜切除无功能重度积水重复上位半肾的安全性及可行性。

方法

回顾性分析东莞市人民医院2016年3月至2020年5月收治的4例重复上位半肾重度积水无功能的患者行腹腔镜上位半肾切除术的临床资料。

结果

4例患者手术均成功完成,无中转开放者。手术时间120~220 min。术中出血量50~300 ml。术后住院时间5~13 d,术后留置引流3~7 d,平均4.3 d。所有患者均无严重并发症发生,随访效果满意。

结论

输尿管脱套技术较好地解决了重复肾切除术中游离肾门血管时容易损伤供应下位半肾的肾血管及容易残留上位半肾组织的难题,可在临床上推广。

Objective

To investigate the safety and feasibility of ureteral degloving technique for the treatment of non-functional severe hydronephrosis duplicated upper pole heminephrectomy by laparoscope.

Methods

Retrospective analysis was conducted on the clinical data of 4 duplex kidneys patients with severe hydronephrosis and non-functional upper-pole moiety who were treated in Dongguan People's Hospital from March 2016 to May 2020.

Results

All 4 patients were successfully operated,and no patients were converted to open surgery. The operation time was 120-220 minutes. Intraoperative bleeding volume was 50-300 ml. Postoperative hospital stay was 5-13 d and postoperative indwelling drainage was 3-7 d. All patients had no serious complications, and the follow-up results were satisfactory.

Conclusions

The technique of ureteral degloving can solve the problem of vascular injury when dissecting the upper-pole renal hilum and incomplete removal of the upper-pole moiety. It is worth popularizing in clinical practice.

图1 腹腔镜下输尿管脱套技术治疗无功能重度积水重复上位半肾切除手术关键步骤
图2 腹腔镜下输尿管脱套技术治疗无功能重度积水重复上位半肾切除手术关键步骤示意图 注:图a示切开肾实质并于输尿管内置入8 F尿管,图b示Ham-o-lok固定输尿管内尿管备脱套用,图c示于两个Ham-o-lok之间剪断输尿管,图d示牵拉尿管脱套并外翻输尿管,图e示脱套牵拉输尿管并切开肾盂,图f示脱套牵拉上位半肾,沿平面向四周剥离
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