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目的:探讨腹腔镜聚丙烯(polypropylene)网带十二肋固定术治疗症状性肾下垂的可行性和疗效。方法:2009年12月以来对4例行立卧位IVU或CT检查确诊为肾下垂患者行后腹腔镜下游离肾脏,采用自行修剪聚丙烯网片呈U型包裹肾脏下极,并用专用钉针将网片两端对合固定于十二肋。结果:4例手术均获成功,无中转开放。手术时间45~100min,平均70min。术中术后无并发症发生。随访3~18个月,术后1个月所有患者腰部酸痛症状较术前明显缓解。术前伴有肉眼血尿和反复出现尿路感染的患者,术后症状消失。术后复查IVU均提示患肾复位固定良好。结论:腹腔镜下聚丙烯网带十二肋固定术治疗症状性肾下垂技术可行,安全有效,并发症少,操作简单,疗效确切,是治疗症状性肾下垂的有效术式,值得推广。
Objective: To investigate the feasibility and efficacy of laparoscopic polypropylene mesh with twelve-rib fixation for symptomatic renal ptosis. METHODS: From December 2009 to April 2008, 4 patients undergoing retroperitoneal IVU or CT were diagnosed as renal palsy and underwent retroperitoneal laparoscopic free radical nephrectomy. The self-primed polypropylene mesh was U-shaped and the lower kidney was wrapped. The two ends of the mesh fixed to twelve ribs. Results: All the 4 surgeries were successful and there was no transfer to open. Surgery time 45 ~ 100min, an average of 70min. No intraoperative and postoperative complications occurred. All the patients were followed up for 3 to 18 months, all patients with lumbar pain symptoms one month after operation were significantly relieved. Preoperative with gross hematuria and recurrent urinary tract infection in patients with postoperative symptoms disappear. IVU postoperative review suggest that the reduction of kidney fixed well. Conclusion: Laparoscopic polypropylene mesh with twelve ribs fixation for the treatment of symptomatic renal prolapse is feasible, safe and effective, with fewer complications, simple operation and definite curative effect. It is an effective surgical treatment of symptomatic renal ptosis and is worth popularizing.