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目的:探讨儿童腹腔镜肾盂成形术的常见并发症及其处理和预防。方法:回顾性分析2014年11月~2016年11月528例行腹腔镜肾盂成形术的患儿临床资料,总结儿童腹腔镜肾盂成形术的常见并发症及处理方法。结果:术中损伤血管2例,低体温1例,肾盂输尿管吻合口撕脱2例,十二指肠损伤1例;术后尿外渗19例,双J管堵塞2例,麻痹性肠梗阻3例,迟发性十二指肠瘘1例,感染和发热42例,肉眼血尿31例,腰痛和尿路刺激征6例,双J管放置不到位、回缩2例,乳糜尿2例,UPJ再次梗阻7例;无急性梗阻性肾功能衰竭患儿。结论:严格的掌握手术适应证、熟练的操作技巧和正确处理术中遇到的困难是预防和处理儿童腹腔镜肾盂成形术并发症的关键。
Objective: To investigate the common complications, treatment and prevention of laparoscopic pyeloplasty in children. Methods: The clinical data of 528 children undergoing laparoscopic pyeloplasty from November 2014 to November 2016 were analyzed retrospectively. The common complications and treatment of laparoscopic pyeloplasty in children were summarized. Results: 2 cases of intraoperative vascular injury, hypothermia in 1 case, pelvic ureter avulsion avulsion in 2 cases, duodenal injury in 1 case; postoperative urinary leakage in 19 cases, double J tube blockage in 2 cases, paralytic ileus 3 cases, delayed duodenal fistula in 1 case, infection and fever in 42 cases, gross hematuria in 31 cases, low back pain and urinary tract irritation in 6 cases, double J tube in place, retraction in 2 cases, chyluria in 2 cases , UPJ again obstruction in 7 cases; no acute obstructive renal failure in children. Conclusion: Strict control of surgical indications, skilled operation skills and correct handling of the intraoperative difficulties encountered are the key to preventing and treating the complications of laparoscopic pyeloplasty in children.