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目的 探讨“输尿管拖出双J管置入”技术,在小儿腹腔镜Anderson-Hynes术中的治疗效果.方法 回顾性分析2015年7月至2016年3月采用“输尿管拖出双J管置入”行腹腔镜Anderson-Hynes术38例肾盂输尿管连接部梗阻(UPJO)患儿的临床资料.其中,男25例,女13例;年龄2～12岁,平均5.2岁;左侧26例,右侧12例.在解剖出肾盂输尿管连接部及上段输尿管后,自狭窄段下方离断输尿管,撤去气腹并拔出下腹部Trocar,将输尿管远端自下腹部戳孔处提出皮肤外,后壁剖开,顺行插入双J管进入膀胱,于剪开的输尿管最低点缝5-0 Vicryl.重新建立气腹后,于腹腔内直视下将输尿管及带针线自戳孔重新置入腹腔.接着按常规方法行腹腔镜肾盂输尿管吻合.结果 38例手术均获得成功,无中转开放手术病例.手术时间78～230 min,平均106 min;双J管置入时间3～8 min,平均5 min.双J管均正确放置,未出现移位.未观察到与“输尿管拖出双J管置入”技术相关的术中或术后并发症.术后住院5～7 d.所有患儿于术后4～6周膀胱镜下拔除双J管.结论 在小儿腹腔镜Anderson-Hynes术中,“输尿管拖出双J管置人”是一个易学、安全、可靠的技术.它解决了双J管置入困难及逆行置管需术中更换体位的问题,并为肾盂输尿管吻合关键的第一针提供了极大便利.“,”Objective To evaluate the efficacies of urethral externalization and stenting during laparoscopic Anderson-Hynes pyeloplasty.Methods From July 2015 to March 2016,38 cases of urethral externalization and stenting were performed during laparoscopic pyeloplasty.There were 25 boys and 13 girls.Left (n =26) and right (n =12) pyeloplasty were performed.Ureteropelvic junction (UPJ) and proximal ureter were dissected.After urethral spatulation,abdomen was desufflated,Trocar removed and proximal ureter liberated to skin level.Bladder stent was inserted in an antegrade fashion.The first stitch was applied to lower ureter with 5-0 vicryl and then abdomen insufflated again.Proximal ureter was returned into abdomen.Laparoscopic urethral anastomosis was performed routinely.Results All operations were successful and all stents correctly placed.The mean operative duration was 106 (78-230) min,mean duration of urethral stenting 5 (3-8) min and mean length of hospitalization 5-7 days.None of them had a conversion into open surgery.And there was no onset of postoperative complications related with urethral externalization and stenting.All stents were removed cystscopically within 4-6 weeks.Conclusions Ureter externalization and stenting is both convenient and reliable during laparoscopic pyeloplasty.And this technique facilitates the insertion of urethral stent and obviates the problems of body repositioning.