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腹腔镜下膀胱输尿管反流手术:42例采用利奇-格雷戈尔膀胱外技术的经验

Laparoscopic surgery of vesicoureteral reflux: an experience in 42 patients with the Lich-Gregoir extravesical technique.

作者信息

Castillo O A, Zubieta R, Yañez R

机构信息

Unidad de Urología y Centro de Cirugía Robótica, Clínica INDISA, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.

出版信息

Actas Urol Esp. 2013 Nov-Dec;37(10):630-3. doi: 10.1016/j.acuro.2013.04.007. Epub 2013 Jul 31.

Abstract

INTRODUCTION

Vesico-ureteral reflux (VUR) is a common congenital anomaly of the urinary tract in the pediatric population, existing controversy regarding its management. Patients selected for treatment options are offered, from endoscopic injection of substances sub-ureteral to ureteral reimplantation surgery.

OBJECTIVE

To evaluate the use of the laparoscopic surgical technique for the treatment of vesico-ureteral reflux, with an analysis of the procedure, results and complications.

MATERIAL AND METHODS

We evaluated a series of 50 ureteral units in 42 patients, who undergoing laparoscopic transperitoneal ureteral reimplant, using the classic technique of Lich-Gregoir detrusorrafia.

RESULTS

The mean operative time was 74 min. There were no intraoperative nor immediate postoperative. At longer follow-up VUR was cured in all cases.

CONCLUSIONS

Laparoscopic surgery is an effective alternative in the surgical treatment of vesico-ureteral reflux, with results comparable to open surgery techniques and over sub-ureteral injection techniques.

摘要

引言

膀胱输尿管反流(VUR)是儿科人群常见的先天性泌尿系统异常,其治疗存在争议。对于选择治疗方案的患者,提供了从输尿管下注射物质到输尿管再植手术等多种治疗方式。

目的

评估腹腔镜手术技术在治疗膀胱输尿管反流中的应用,并分析手术过程、结果及并发症。

材料与方法

我们评估了42例患者的50个输尿管单位,这些患者接受了腹腔镜经腹输尿管再植术,采用经典的利奇-格雷戈尔逼尿肌固定术。

结果

平均手术时间为74分钟。术中及术后即刻均无并发症。在更长时间的随访中,所有病例的VUR均得到治愈。

结论

腹腔镜手术是治疗膀胱输尿管反流的一种有效替代方法,其结果与开放手术技术相当,优于输尿管下注射技术。

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