[1]丁彦才 李飞宇* 刘丽① 杨涛 马小云 席海峰 邵永祥 王乔峰.腹腔镜联合膀胱软镜或输尿管软镜治疗肾盂输尿管连接部梗阻合并肾结石[J].中国微创外科杂志,2022,01(6):459-462.
　Ding Yancai*,Li Feiyu*,Liu Li,et al.Laparoscopic Pyeloplasty Combined With Flexible Cystoscopy or Ureteroscopy for Ureteropelvic Junction Obstruction With Renal Calculi[J].Chinese Journal of Minimally Invasive Surgery,2022,01(6):459-462.
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腹腔镜联合膀胱软镜或输尿管软镜治疗肾盂输尿管连接部梗阻合并肾结石()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年6期
页码:
459-462
栏目:
临床研究
出版日期:
2022-10-11

文章信息/Info

Title:
Laparoscopic Pyeloplasty Combined With Flexible Cystoscopy or Ureteroscopy for Ureteropelvic Junction Obstruction With Renal Calculi
作者:
丁彦才 李飞宇* 刘丽① 杨涛 马小云 席海峰 邵永祥 王乔峰
(解放军第942医院泌尿外科，银川750021)
Author(s):
Ding Yancai*;  Li Feiyu*;  Liu Li;  et al.
*Department of Urology, No. 942 Hospital of PLA, Yinchuan 750021, China
关键词:
肾盂输尿管连接部梗阻; 腹腔镜肾盂成形术; 输尿管软镜; 肾结石
Keywords:
Ureteropelvic junction obstruction; Laparoscopic pyeloplasty; Flexible ureteroscope; Renal calculi
文献标志码:
A
摘要:
目的探讨腹腔镜肾盂成形联合电子膀胱软镜或输尿管软镜治疗肾盂输尿管连接部梗阻(ureteropelvic junction obstruction，UPJO)合并肾结石的疗效。方法2018 年1月～2021年5月我科采用腹腔镜联合膀胱软镜或输尿管软镜治疗26 例 UPJO 合并肾结石。腹腔镜下游离扩张的肾盂和输尿管上段，在肾盂拟裁剪处先切开1 cm，置入输尿管软镜或膀胱软镜，直视下用三边或四边套石网篮取出结石，较大结石取出困难时置入钬激光碎石，结石清除后采用 AndersonHyens法行腹腔镜肾盂成形术。结果1例术中置入trocar导致肝损伤中转开放手术。26例均一期完成手术，结石均完全清除。手术时间120～260 min，(130.1±30.3) min。住院时间(7.5±2.0) d。术后 8 周拔除双 J 管。术后3个月复查CTU示肾盂输尿管连接部通畅，肾内无结石残留，无积水加重。26例随访7~29个月，23例治愈，3例好转。结论腹腔镜肾盂成形术联合电子膀胱软镜或输尿管软镜同期治疗 UPJO 合并肾结石疗效满意，安全、可靠。
Abstract:
ObjectiveTo investigate the efficacy of laparoscopic pyeloplasty combined with flexible electronic cystoscopy or ureteroscopy in the treatment of ureteropelvic junction obstruction (UPJO) with renal calculi.MethodsA retrospective analysis was made on clinical data of 26 UPJO patients with renal calculi admitted from January 2018 to May 2021. Laparoscopy was used to free the expanded renal pelvis and upper ureter during the operation. The renal pelvis was incised for 1 cm at the intended cutting site, and a flexible electronic cystoscope or ureteroscope was placed. Under direct vision, the calculi were taken out with a threesided or foursided stone basket. The holmium laser lithotripsy was applied in case of difficulty in removing large stones. After stone removal, the AndersonHyens method was used to perform laparoscopic pyeloplasty.ResultsOne case of liver injury caused by intraoperative placement of trocar was converted to open surgery. All the 26 cases were operated at one stage, and the stones were completely removed. The operation time was 120-260 min (mean, 130.1±30.3 min), and the hospital stay was (7.5±2.0) d. The double J tube was removed 8 weeks after the operation. Three months after operation, review with CTU showed that the ureteropelvic junction was unobstructed, and there was no residual stone in the kidney or aggravation of hydronephrosis. All the 26 cases were followed up for 7-29 months, showing that 23 cases of hydronephrosis were cured and 3 cases were improved.ConclusionLaparoscopic pyeloplasty combined with flexible electronic cystoscopy or ureteroscopy in the treatment of UPJO with renal calculi is safe and reliable.

参考文献/References:

[1]《腹腔镜肾盂成型术手术规范专家共识》专家组.腹腔镜肾盂成型术手术规范专家共识.微创泌尿外科杂志,2020,9(6):361-366.
[2]Stasinou T, Bourdoumis A, Masood J. Forming a stone in pelvic ureteric junction obstruction：Cause or effect？Int Braz J Urol,2017,43(1):13-19.
[3]杨昆霖，李学松，周利群.IUPU经腹腹腔镜联合膀胱软镜肾盂取石及肾盂成型.泌尿外科杂志(电子版),2015,7(3):4-6.
[4]王福利,杨力军,刘飞,等.机器人辅助腹腔镜联合输尿管软镜治疗合并肾结石的肾盂输尿管连接部梗阻.微创泌尿外科杂志,2017,6(2):79-81.
[5]曹亚磊,任祥斌,张沂南.腹腔镜肾盂成形术联合输尿管硬镜钬激光碎石术治疗功能性孤立肾肾盂输尿管连接部梗阻合并肾结石一例报道并文献复习.泌尿外科杂志，2019,12(2):36-39.
[6]马立飞,周辉霞,陈绍君,等.腹腔镜联合输尿管软镜一期治疗小儿肾积水并发复杂肾结石的初步研究.微创泌尿外科杂志,2018,7(1):14-18.
[7]Juan GR, Gregorio S, Leslie CS, et al.Approach to kidney stones associated with ureteropelvic junction obstruction during laparoscopic pyeloplasty. Cent Eur J Urol,2014,66(4):440-444.
[8]刘启明,马鑫,郑涛,等.后腹腔镜下肾盂成形术联合膀胱软镜治疗肾盂输尿管连接部梗阻合并肾结石(附 5 例报告).微创泌尿外科杂志,2013,2(3):171-173.
[9]唐启胜,王磊,李瑞晓,等.腹腔镜肾盂成形联合改良经皮肾镜碎石术治疗肾盂输尿管连接部梗阻合并肾下盏结石疗效分析.现代泌尿外科杂志,2020,25(9):789-792.
[10]郑霁，鄢俊安，李为兵,等.达芬奇机器人辅助腹腔镜联合输尿管硬镜一期治疗肾盂输尿管连接部梗阻合并肾结石.微创泌尿外科杂志,2014,8(4):197-199.
[11]韩利忠,李明明,卢冠军,等.经皮肾镜联合腔内切开手术治疗肾结石合并肾盂输尿管连接部梗阻.中国微创外科杂志,2018,18(5):409-411.
[12]张韬,丁彦才,姜旭,等.经皮肾镜治疗肾盂输尿管连接部狭窄合并肾结石.中国微创外科杂志,2013,13(3):268-270.
[13]张韬，丁彦才，姜旭，等.微创经皮肾镜钬激光联合气压弹道碎石术治疗肾、输尿管上段结石(附1870例报道).中国微创外科杂志,2013,13(6):513-515.
[14]Skolarikos A. Laparoscopic urinaly stone Surgery: an updated evidencebase view. Urol Res,2010,38(5):337-344.
[15]Lusuardi L, Janetschek G. Indications and outcomes of laparoscopic ureterorenal stone surgery. Curr Opinurol,2011,21(2):161-165.
[16]张旭，许凯，张军，等.后腹腔镜下Hellstrom术治疗异位血管 导致的肾盂输尿管连接处狭窄.中华泌尿外科杂志,2007,28(7):450-452．

备注/Memo

备注/Memo:
*通讯作者，Email：824798002@qq.com ①放射科
更新日期/Last Update: 2022-10-11