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目的:观察腹腔镜下乳头植入式输尿管膀胱再植术治疗输尿管下段狭窄及先天性巨输尿管的临床效果。方法:2008年8月~2014年3月对12例输尿管下段狭窄及先天性巨输尿管患者实施腹腔镜下乳头植入式输尿管膀胱再植术。9例为单侧输尿管末端狭窄(左侧5例,右侧4例);3例(4条)为先天性巨输尿管。观察手术时间、术中出血量、术后住院时间、并发症及手术疗效。结果:12例患者均成功完成腹腔镜下乳头植入式输尿管膀胱再植术,手术时间平均136min(58~250min),术中出血量<50ml,住院时间5~7d,术后1个月拔除双J管。术后患者腰痛症状即消失,随访3~48个月,B超及IVU提示肾积水消退,排空良好,未再发生狭窄;膀胱造影未见输尿管反流。结论:腹腔镜下乳头植入式输尿管膀胱再植术治疗输尿管末端狭窄及先天性巨输尿管是一种安全、有效的微创治疗方法。
Objective: To observe the clinical effect of laparoscopic ureter implanted ureteral bladder replantation in the treatment of lower ureter stenosis and congenital giant ureter. Methods: From August 2008 to March 2014, 12 patients with ureteral stricture and congenital giant ureter underwent laparoscopic papilla implantation of ureteral bladder. 9 cases of unilateral ureteral stenosis (left 5 cases, right 4 cases); 3 cases (4) for the giant ureter. Observation of operation time, intraoperative blood loss, postoperative hospital stay, complications and surgical treatment. Results: All the 12 patients underwent laparoscopic papilla implantation of ureteric vesicle. The average operation time was 136min (58 ~ 250min), the blood loss was less than 50ml, the hospitalization time was 5 ~ 7d, and one month after operation Double J tube. Postoperative patients with low back pain symptoms disappear, followed up for 3 to 48 months, B-and IVU prompted hydronephrosis subsided, emptying was good, no recurrence of stenosis; ureteroscopic ureteral reflux was not seen. Conclusion: Laparoscopic papilla implantation of ureteral bladder replantation of ureteral terminal stenosis and congenital giant ureter is a safe and effective minimally invasive treatment.