小儿上尿路梗阻的腹腔镜手术治疗
JOURNAL OF NEW MEDICINE(2009)
Abstract
目的 探讨腹腔镜手术治疗小儿上尿路梗阻所致肾积水病变的治疗效果,明确腹腔镜手术在小儿泌尿外科的应用价值.方法 采用腹腔镜手术治疗小儿上尿路梗阻32例(29例经后腹腔,3例经腹),其中22例行离断式肾盂输尿管成形术,3例输尿管息肉切除.肾盂输尿管成形术,3例肾盂输尿管切开取石术,1例仅行迷走血管离断术,3例经腹腔腹腔镜输尿管裁剪膀胱再植术.结果 32例腹腔镜手术成功.手术时间60~260(平均170)min,术中平均出血量15~20 ml.术后3~6个月随访32例肾积水症状消失.B超检查肾集合系统分离减轻.8例行IVU检查肾显影增快,输尿管通畅.3例输尿管再植术后行膀胱逆行造影无反流.结论 腹腔镜治疗小儿上尿路梗阻疾病可行、安全,且具有伤口小、损伤轻、恢复快的优势.
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