【摘要】 目的探讨应用气膀胱腹腔镜治疗膀胱输尿管连接部先天畸形的效果。方法18例患儿(男11例,女7例)共22根输尿管。年龄3个月~7岁,平均3.6岁。膀胱输尿管反流9例(其中双侧反流4例),膀胱憩室伴输尿管口狭窄2例,输尿管口狭窄伴同侧肾积水7例。经球囊尿管注入CO2气体,以16mmHg的压力建立气膀胱。在脐下及其两侧放置trocar,用丝线与膀胱及腹壁固定。分别导入膀胱镜及操作器械,行输尿管狭窄段切除及膀胱输尿管移植,术后留置导尿。结果1例因输尿管回缩至膀胱外而中转开放,余17例均获成功。手术时间单侧13例平均130min(110~145min),双侧4例平均242min(225~250min)。住院9~12d。术后随访6个月~5年,平均3.8年。排尿性膀胱尿道造影(MCU)检查,无输尿管反流。1例术后3个月轻度尿道感染,行包皮环切术后无复发。结论在熟练掌握了腹腔镜技术后,气膀胱腹腔镜技术治疗膀胱输尿管连接部先天畸形,可以取得良好效果。更多还原

【Abstract】 Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.更多还原