Wang Ping, Xia Dan, Ma Qi, Wang Shuo
Department of Urology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China.
Department of Urology, Ningbo First Hospital, the Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China.
Urology. 2014 Dec;84(6):1351-4. doi: 10.1016/j.urology.2014.07.029. Epub 2014 Sep 19.
To report our experience with retroperitoneal laparoscopic pyeloplasty for the management of ureteropelvic junction (UPJ) obstruction in patients with horseshoe kidneys (HSKs).
Between March 2005 and May 2012, 2 boys, 5 men, and 1 woman (mean age, 23.9 years; range, 7-42 years) with HSKs underwent retroperitoneal laparoscopic dismembered pyeloplasties for UPJ obstructions with transections of the isthmuses. One patient had a renal calculus that was extracted during surgery. The follow-up included clinical evaluations, ultrasonography, intravenous urography, and diuretic renography.
Retroperitoneal laparoscopic dismembered pyeloplasty was feasible in all cases. The median operative time was 192 minutes (range, 148-252 minutes), and there were no perioperative complications. The mean hospital stay was 5.8 days (range, 4-7 days). The mean follow-up time was 45 months (range, 18-96 months). All patients were asymptomatic and exhibited decreased pelvic dilation at follow-up.
The retroperitoneal laparoscopic approach is feasible and safe for pyeloplasty in UPJ obstruction associated with HSK. Isthmectomy and a fully mobilized kidney offer better surgical exposure during the operation.
报告我们应用腹膜后腹腔镜肾盂成形术治疗马蹄肾（HSK）患者输尿管肾盂连接部（UPJ）梗阻的经验。
2005年3月至2012年5月，2名男孩、5名男性和1名女性（平均年龄23.9岁；范围7 - 42岁）患有马蹄肾，因UPJ梗阻接受了腹膜后腹腔镜离断性肾盂成形术，术中横断峡部。1例患者有肾结石，手术中取出。随访包括临床评估、超声检查、静脉肾盂造影和利尿肾图检查。
所有病例腹膜后腹腔镜离断性肾盂成形术均可行。中位手术时间为192分钟（范围148 - 252分钟），无围手术期并发症。平均住院时间为5.8天（范围4 - 7天）。平均随访时间为45个月（范围18 - 96个月）。所有患者均无症状，随访时肾盂扩张减轻。
腹膜后腹腔镜手术治疗与HSK相关的UPJ梗阻的肾盂成形术是可行且安全的。峡部切除术和充分游离肾脏可在手术中提供更好的手术视野。
