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目的:总结3D腹腔镜上尿路重建手术的临床经验,发挥3D腹腔镜技术在手术中的优势。方法:回顾性分析我院2013年3~8月采用3D腹腔镜技术行上尿路重建手术患者12例的临床资料及手术方法:肾盂输尿管连接部梗阻9例,男5例,女4例,年龄9~36岁,平均19岁,左侧6例,右侧3例;输尿管下端梗阻3例,均为女性,年龄22~27岁,平均24岁,均未生育,左侧2例,右1例。肾盂输尿管梗阻采用3D腹腔镜UPJ离断成形术(Anderson-Hynes术),输尿管下端梗阻采用3D腹腔镜输尿管膀胱再植术。均经腹膜外途径完成手术。结果:UPJ离断成形术手术时间平均135min,输尿管膀胱再植术手术时间平均95min。12例患者双J管取出后复查,肾脏积水均有所减轻。结论:3D腹腔镜技术利用其高清的三维立体视野,减小了手术难度,增加了手术精确度,同时又未明显增加患者的费用,符合我国国情,值得临床推广。
OBJECTIVE: To summarize the clinical experience of 3D laparoscopic urinary tract reconstruction and to give full play to the advantages of 3D laparoscopy in surgery. Methods: Retrospectively analyzed the clinical data and surgical methods of 12 cases undergoing urethral reconstruction with 3D laparoscopy from March to August 2013 in our hospital: 9 cases of ureteropelvic junction obstruction, 5 males and 4 females, Aged 9 to 36 years old, average 19 years old, left 6 cases, right 3 cases; ureter obstruction in 3 cases, were female, aged 22 to 27 years, mean 24 years, no childbirth, left and right in 2 cases 1 case. Ureteropelvic obstruction using 3D laparoscopic UPJ (Anderson-Hynes surgery), ureterobiliary obstruction using 3D laparoscopic ureteral bladder replantation. The surgery was done extraperitoneally. Results: The average time of UPJ dissociative angioplasty was 135 minutes, and the duration of ureteric bladder replantation was 95 minutes. Twelve patients with double J tube removed after review, kidney hydronephrosis have been reduced. Conclusion: The 3D laparoscopic technique uses its high-definition three-dimensional field of vision to reduce the difficulty of surgery and increase the accuracy of surgery without significantly increasing the cost of patients, which is in line with China’s national conditions and worthy of clinical promotion.