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目的探讨腹腔镜结合开放手术在肾盂成形术中的应用价值。方法肾盂输尿管连接部梗阻患者45例,经腹腹腔镜下游离肾盂及部分输尿管上段,将正对肾盂输尿管连接部体表投影水平的套管戳口向头侧延长1～2cm,自该切口将肾盂输尿管连接部提出腹壁外进行成形操作。结果45例手术均获成功。手术时间40～85min,平均58min；术中出血量15～30ml,平均22ml。术中术后无并发症。34例随访3～36个月,平均11个月,IVU检查吻合口无梗阻,B超提示患肾积水减轻。结论与开放手术和全腹腔镜手术相比,肾盂成形术中联合应用腹腔镜与开放手术技术可减少腹腔镜手术的操作难度,缩短手术时间,并不明显增加腹壁创伤,值得临床推广应用。
Objective To investigate the value of laparoscopy combined with open surgery in pyeloplasty. Methods 45 patients with ureteropelvic junction obstruction, abdominal laparoscopic free pelvis and part of the upper ureter, will be on the surface of the pelvis and ureter junctional projection of the level of cannulated catheter to the head side of the mouth to extend 1 ~ 2cm, from the incision The ureteropelvic junction presents the shaping operation outside the abdominal wall. Results 45 cases were successful. Surgery time 40 ~ 85min, an average of 58min; intraoperative blood loss 15 ~ 30ml, an average of 22ml. No postoperative complications. 34 cases were followed up for 3 to 36 months, an average of 11 months, IVU examination anastomotic obstruction, B-ultrasound prompted reduction of hydronephrosis. Conclusion Compared with open surgery and total laparoscopic surgery, laparoscopic and open surgery in combination with laparoscopic and open laparoscopic surgery can reduce the difficulty of laparoscopic operation, shorten the operation time, and does not significantly increase the abdominal trauma, worthy of clinical application.