【摘要】 目的:探讨机器人辅助腹腔镜肾盂成型术联合输尿管软镜取石术治疗合并肾结石的肾盂输尿管连接部梗阻(UPJO)的可行性及有效性。方法:回顾性分析2013年3月~2015年9月因UPJO合并肾结石而接受机器人辅助腹腔镜肾盂成型术联合输尿管软镜取石手术治疗的12例患者临床资料,左侧UPJO 5例,右侧UPJO 7例,其中合并单发肾下极结石7例,多发肾结石5例。B超提示重度肾积水4例、中度5例、轻度3例。结果:12例患者均顺利完成手术,总手术时间平均(128.6±26.3)min,软镜手术时间平均(30.2±13.5)min,失血量平均(37.1±9.7)ml,住院时间平均(6.2±1.5)d,无严重手术并发症,无中转开放手术。术后随访12~42个月,结石清除率达100%;12例患者腰痛症状均消失,逆行肾盂造影示UPJO吻合口无狭窄,肾积水减轻;4例重度肾积水者中1例转为中度、3例转为轻度;5例中度积水者中2例转为轻度、3例积水消失;3例轻度肾积水者积水消失。结论:机器人辅助腹腔镜联合输尿管软镜手术治疗合并肾结石的UPJO临床效果好,具有可行性。更多还原

【Abstract】 Objective:To evaluate the efficacy and feasibility of the robot-assisted laparoscopic pyeloplasty(RALP)combined with flexible ureteroscope lithtripsy(f-URL)for treatment of ureteropelvic junction obstruction(UPJO)with renal calculi.Methods:We retrospectively reviewed the records of 12patients who underwent RALP and f-URL for UPJO with renal calculi from March 2013to September 2015.Three cases had solitary stones located at the lower calyx,and the other two had multiple stones.Of 12cases of UPJO,there were 7cases in the right kidney,and 5cases in the left kidney.Seven cases had solitary stones located at the lower calyx,and the rest 5cases had multiple stones.B-ultrasound examination showed that severe hydronephrosis occurred in 4cases,intermediate in 5cases,and mild in 3cases.Results:The operation was successful in all the 12patients with no severe complications.The average total operation time was(128.6±26.3)min and the average f-URL time was(30.2±13.5)min.The average blood loss was(37.1±9.7)mL and the average hospital stay length was(6.2±1.5)days.No conversions to open surgery were required.During the postoperative follow-up period of 12to 42months,the stone-free rate was 100%.Lumbago disappeared in 12cases and there was no stricture at UPJ by retrograde pyelography.Hydronephrosis was remitted(among 4cases with severe hydronephrosis,hydrops remitted from severe to interm ediate in 1and to mild in 3;among 5cases with intermediate hydronephrosis,hydrops remitted from interm ediate to mild in 2and 3had resolution:3cases with mild hydronephrosis had resolution).Conclusions:RALP combined with f-URL is effective and feasible for treatment of UPJO with renal calculi.更多还原