Shao Pengfei, Qin Chao, Ju Xiaobing, Meng Xiaoxin, Li Jie, Lv Qiang, Zhang Wei, Xu Zhengquan, Yin Changjun
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Urol Int. 2011;87(3):304-8. doi: 10.1159/000329368. Epub 2011 Aug 24.
Anastomosis of ureteropelvic junction with a laparoscope for the treatment of ureteropelvic junction obstruction (UPJO) is a time-consuming and technically challenging procedure. We present our experience of laparoscopic dismembered pyeloplasty and compare clinical outcomes of two different suture techniques.
From September 2003 to June 2010, 105 laparoscopic dismembered pyeloplasties were performed in our department. All procedures were done using the retroperitoneal approach. According to the suture methods (interrupted or running), the patients were divided into two groups. An indwelling stent was placed intraoperatively in an antegrade manner. Data on operation time, blood loss and complications were collected.
All procedures were completed without open conversion. Mean operation time and anastomotic time were 96 (55-150) and 36 min (15-70), respectively. A significant decrease of operation and anastomosis time was seen when running sutures were applied. Mean blood loss was 54 ml (30-100). The total complication rate was 7.6%. No anastomotic stricture occurred. The average hospitalization stay was 7 days. During 5-85 months of follow-up, hydronephrosis was alleviated in all cases.
Laparoscopic dismembered pyeloplasty for the treatment of UPJO can provide satisfactory clinical outcomes. Higher surgical efficiency and lower complication rates can be obtained by using the running suture method.
采用腹腔镜行肾盂输尿管连接部吻合术治疗肾盂输尿管连接部梗阻（UPJO）是一项耗时且技术要求高的手术。我们介绍我们的腹腔镜离断性肾盂成形术经验，并比较两种不同缝合技术的临床效果。
2003年9月至2010年6月，我科共进行了105例腹腔镜离断性肾盂成形术。所有手术均采用后腹腔镜入路。根据缝合方法（间断或连续）将患者分为两组。术中顺行置入输尿管支架管。收集手术时间、出血量及并发症等数据。
所有手术均未中转开放手术。平均手术时间和吻合时间分别为96（55～150）分钟和36分钟（15～70）。采用连续缝合时，手术时间和吻合时间显著缩短。平均出血量为54毫升（30～100）。总并发症发生率为7.6%。未发生吻合口狭窄。平均住院时间为7天。随访5～85个月，所有病例肾积水均减轻。
腹腔镜离断性肾盂成形术治疗UPJO可取得满意的临床效果。采用连续缝合方法可提高手术效率并降低并发症发生率。
