Arap Marco Antonio, Andrade Hiury, Torricelli Fabio Cesar Miranda, Denes Francisco Tibor, Mitre Anuar Ibrahim, Duarte Ricardo Jordão, Srougi Miguel
Division of Urology, University of Sao Paulo Medical School, São Paulo, Brazil,
Int Urol Nephrol. 2014 May;46(5):865-9. doi: 10.1007/s11255-013-0591-z. Epub 2013 Nov 12.
To report on the largest series of laparoscopic ureterocalicostomies done for complicated upper urinary obstruction.
We retrospectively reviewed the data from 6 transperitoneal laparoscopic ureterocalicostomies performed in our institution from January 2008 to January 2012. Symptomatic complicated upper urinary obstruction was the main reason for all the procedures. The recorded data included age, gender, clinical presentation, duration of symptoms, laterality, mean operative time, hospital stay, complications and clinical and functional outcomes.
The median patient age was 20.1 (2-44) years, and all patients were females. Patients underwent laparoscopic ureterocalicostomy due to previous failed procedures (3 patients), anatomic abnormalities (2 patients) and a severe upper ureteral stenosis (1 patient). The median operative time was 215 (180-270) min. There were no major complications. There were no conversions to open surgery. In a median follow-up of 30 (8-56) months, all patients presented with clinical and radiological improvement with no signs of obstruction. In all cases, the postoperative renal scintigraphy revealed a T1/2 lower than 10 min.
Laparoscopic ureterocalicostomy is feasible and associated with high success rate in well-selected cases with complicated upper urinary obstructions.
报告针对复杂性上尿路梗阻所施行的最大规模腹腔镜输尿管肾盂吻合术系列病例。
我们回顾性分析了2008年1月至2012年1月在我院进行的6例经腹腹腔镜输尿管肾盂吻合术的数据。有症状的复杂性上尿路梗阻是所有手术的主要原因。记录的数据包括年龄、性别、临床表现、症状持续时间、病变侧别、平均手术时间、住院时间、并发症以及临床和功能结局。
患者的年龄中位数为20.1(2 - 44)岁,所有患者均为女性。患者因既往手术失败(3例)、解剖异常(2例)和严重的上段输尿管狭窄(1例)而接受腹腔镜输尿管肾盂吻合术。手术时间中位数为215(180 - 270)分钟。无重大并发症。无中转开放手术情况。在中位随访30(8 - 56)个月时,所有患者临床和影像学均有改善,无梗阻迹象。所有病例术后肾闪烁显像显示半排时间低于10分钟。
对于精心挑选的复杂性上尿路梗阻病例,腹腔镜输尿管肾盂吻合术是可行的,且成功率高。