Recker F, Subotic B, Goepel M, Tscholl R
Urological Clinics, Kantonsspital Aarau, Switzerland.
J Urol. 1995 May;153(5):1601-4. doi: 10.1016/s0022-5347(01)67472-x.
As a reconstructive laparoscopic procedure, dismembered pyeloplasty was done in 5 patients: the laparoscopic procedure was completed in 4 and converted to an open operation in 1. Within this series operative time decreased from 390 to 190 minutes. The main operating time was devoted to laparoscopic suturing of the anastomosis. Spreading the renal pelvis by either pulling the sutures transcutaneously or with intra-abdominal stay sutures improved visualization and facilitated the anastomosis. Mean postoperative hospitalization was 8 days (range 7 to 10). After a mean followup of 9 months (range 6 to 15) excretory urography and renal scintigraphy revealed significant radiographic improvement and no obstruction in 4 patients. Compared to open pyeloplasty and endo-pyelotomy, laparoscopic pyeloplasty may combine the advantages of open surgery (excision of the stenosis and reduction of the renal pelvis) with those of minimally invasive surgery (minimal postoperative morbidity), provided the operative time can be shortened and the technique simplified.
作为一种重建性腹腔镜手术，对5例患者实施了离断性肾盂成形术：4例完成了腹腔镜手术，1例转为开放手术。在这组病例中，手术时间从390分钟降至190分钟。主要手术时间用于腹腔镜下吻合口缝合。通过经皮牵拉缝线或使用腹腔内留置缝线来扩张肾盂，改善了视野并便于吻合。术后平均住院时间为8天（范围7至10天）。平均随访9个月（范围6至15个月）后，排泄性尿路造影和肾闪烁扫描显示4例患者影像学有显著改善且无梗阻。与开放性肾盂成形术和内镜肾盂切开术相比，腹腔镜肾盂成形术可能兼具开放手术（切除狭窄段和缩小肾盂）和微创手术（术后发病率低）的优点，前提是手术时间能够缩短且技术能够简化。
