Chuanyu Sun, Guowei Xia, Ke Xu, Qiang Ding, Yuanfang Zhang
Department of Urology, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
Urology. 2009 Nov;74(5):1036-40. doi: 10.1016/j.urology.2009.04.083. Epub 2009 Aug 5.
To assess the feasibility and efficacy of retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty in the treatment of ureteropelvic junction obstruction (UPJO).
Between August 2003 and June 2007, retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty was performed in 150 patients diagnosed with UPJO. All patients were assessed preoperatively by imaging examinations (ultrasonography, computerized tomography, and intravenous or retrograde urography) and isotope diuretic renography. Additionally, of the 150 cases, 16 patients with renal calculi underwent concomitant pyelolithotomy.
All surgeries were successful. No conversion to open surgery was observed. The average operating time, blood loss, and postoperative hospital stay was 105 minutes (range 95-190), 35 mL (range 20-80), and 7.4 days (range 6-12), respectively. A crossing vessel was encountered in 70 (46.7%) patients. Concomitant renal calculi were successfully removed in 11 patients. Two cases presented with urinary leakage that disappeared on the 11th and 12th postoperative day, respectively. Success rate was 98% at a mean follow-up of 16 months (range 12-24).
Retroperitoneal laparoscopic pyeloplasty provides a minimal invasive treatment modality with low morbidity, short hospital stay, and quick postoperative recovery for patients with UPJO. In experienced hands, laparoscopic pyeloplasty is an effective alternative treatment for UPJO.
评估后腹腔镜离断性Anderson-Hynes肾盂成形术治疗肾盂输尿管连接部梗阻（UPJO）的可行性和疗效。
2003年8月至2007年6月，对150例诊断为UPJO的患者行后腹腔镜离断性Anderson-Hynes肾盂成形术。所有患者术前均行影像学检查（超声、计算机断层扫描、静脉肾盂造影或逆行肾盂造影）及同位素利尿肾图检查。此外，150例患者中有16例合并肾结石，同期行肾盂切开取石术。
所有手术均成功，无中转开放手术病例。平均手术时间、出血量及术后住院时间分别为105分钟（95 - 190分钟）、35毫升（20 - 80毫升）及7.4天（6 - 12天）。70例（46.7%）患者发现有交叉血管。11例合并肾结石患者成功取石。2例出现尿漏，分别于术后第11天和第12天消失。平均随访16个月（12 - 24个月），成功率为98%。
后腹腔镜肾盂成形术为UPJO患者提供了一种微创治疗方式，具有发病率低、住院时间短、术后恢复快等优点。在经验丰富的医生操作下，腹腔镜肾盂成形术是治疗UPJO的一种有效替代方法。
