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目的探讨通过腹膜后途径应用腹腔镜治疗下腔静脉后输尿管成形术的手术技巧和临床疗效。方法 12例采用后腹腔镜手术,采用离断输尿管,移至下腔静脉腹侧端端吻合,恢复正常解剖关系。结果其中11例手术成功,无漏尿,腰痛消失,3个月后复查B超,静脉尿路造影(IVU)右肾积水消失,吻合口无狭窄。下腔静脉损伤中转开放手术1例,无并发症。结论在下腔静脉腹侧恢复输尿管正常解剖,不切除下腔静脉后段输尿管,具有安全、有效、技术难度降低、吻合口狭窄概率减少的优点。后腹腔镜手术具有美观、术后疼痛轻、恢复快优点,有望成为下腔静脉后输尿管治疗的首选方法。
Objective To investigate the surgical technique and clinical efficacy of transperitoneal laparoscopic ureteroplasty after ureteroplasty. Methods Twelve patients underwent retroperitoneal laparoscopic surgery. The ureter was removed and anastomosed to the vena cava of the inferior vena cava to restore the normal anatomic relationship. Results Of the 11 cases, the operation was successful, no leakage of urine and low back pain disappeared. After 3 months, B-ultrasound and IVU right hydronephrosis disappeared without anastomosis. Inferior vena cava injury in 1 case of open surgery, no complications. Conclusions The normal anatomy of the ureter in the ventral vena cava of the inferior vena cava can be restored without removing the ureter of the posterior segment of the inferior vena cava, which is safe and effective, with less technical difficulty and less probability of anastomotic stenosis. Retroperitoneal laparoscopic surgery has the advantages of good appearance, light postoperative pain and fast recovery, which is expected to become the preferred method of ureter treatment after inferior vena cava.