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目的:探讨后腹腔镜手术治疗成人重复肾输尿管畸形的临床经验及手术疗效。方法:回顾分析2006年11月至2011年9月为18例成人重复肾输尿管畸形患者行后腹腔镜手术的临床资料,其中男6例,女12例,平均(30.2±7.8)岁。18例重复肾均位于肾上极,其中左侧13例,右侧5例。结果:18例手术均顺利完成,无一例中转开放手术,围手术期无严重并发症发生。手术时间平均(103±24.5)min,术中出血量平均(45.3±21.6)ml,术中肾静脉损伤1例,术后发生尿漏1例,术后平均住院(5.5±1.7)d。平均随访(41.3±15.5)个月,患者术前原有症状消失,肾功能正常,术后3个月复查CTU或MRU检查,未见重复肾。结论:后腹腔镜重复肾输尿管切除术安全、有效,具有患者创伤小、康复快的优点,可作为治疗成人重复肾输尿管畸形的首选方法。
Objective: To investigate the clinical experience and surgical treatment of retroperitoneal laparoscopic surgery in the treatment of adult patients with repeated renal ureter deformity. Methods: A retrospective analysis was performed on the clinical data of 18 cases of retroperitoneal ureteral deformity patients from November 2006 to September 2011, including 6 males and 12 females, with an average of (30.2 ± 7.8) years. Eighteen cases of repeat kidney were located in the upper pole of the kidney, including 13 cases on the left and 5 cases on the right. Results: All the 18 cases were successfully completed. No case was transferred to open surgery. No serious complications occurred during perioperative period. The average operation time was (103 ± 24.5) min. The mean amount of bleeding during operation was (45.3 ± 21.6) ml. One case of renal vein injury during operation and 1 case of postoperative urinary leakage. The average postoperative hospital stay was 5.5 ± 1.7 days. The average follow-up (41.3 ± 15.5) months, the patient’s original symptoms disappeared before surgery, normal renal function, 3 months after the review CTU or MRU examination, no duplication of the kidneys. Conclusion: Retroperitoneal laparoscopic radical nephroureterectomy is safe and effective. It has the advantages of small trauma and quick recovery. It can be used as the first choice for treating adult ureter recurrence.