Gill I S, Munch L C, Lucas B A, Das S
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, USA.
Urology. 1995 Nov;46(5):747-50. doi: 10.1016/S0090-4295(99)80317-3.
To report the initial experience with retroperitoneoscopic nephroureterectomy for symptomatic, end-stage vesicoureteral reflux.
Two patients underwent a nephroureterectomy by a four-port retroperitoneal laparoscopic approach. In 1 patient, a double-balloon technique was used to dissect the pelvic extraperitoneal space and gain access to the juxtavesical ureter. In the second patient, the distal ureter was mobilized with routine laparoscopic dissection techniques.
Operative time was 6 and 5.5 hours, respectively, and mean hospital stay was 4 days. Mean patient follow-up is 17.5 months.
The technique of retroperitoneoscopic nephroureterectomy is in evolution; until now, a major concern has been the inadequate access to the distal ureter through a completely retroperitoneoscopic approach. Described herein is a double-balloon technique that significantly facilitates dissection of the juxtavesical ureter during a retroperitoneal laparoscopic nephroureterectomy.
报告经后腹腔镜肾输尿管切除术治疗有症状的终末期膀胱输尿管反流的初步经验。
2例患者采用四孔后腹腔镜入路行肾输尿管切除术。1例患者采用双球囊技术分离盆腔腹膜外间隙并显露膀胱旁输尿管。第2例患者采用常规腹腔镜分离技术游离输尿管远端。
手术时间分别为6小时和5.5小时，平均住院时间为4天。患者平均随访17.5个月。
后腹腔镜肾输尿管切除术技术尚在发展中；迄今为止，一个主要问题是通过完全后腹腔镜入路难以充分显露输尿管远端。本文描述的双球囊技术可显著便于后腹腔镜肾输尿管切除术中膀胱旁输尿管的分离。
