【摘要】 目的:探讨腹腔镜联合会阴小切口技术治疗复杂性后尿道狭窄的疗效及安全性。方法:回顾性分析金华市中心医院泌尿外科2014年9月-2017年9月收治的26例复杂性后尿道狭窄患者行腹腔镜联合会阴小切口术式治疗的临床资料。结果:26例患者均顺利完成手术,手术时间130～230 min,平均(160±55)min;术后住院时间3～11 d,平均(7.6±1.4)d;术后2周拔除尿管,术后随访7～36个月,平均18个月,无一例失访。其中24例患者拔管后排尿通畅,最大尿流率(19.0±4.6)mL/s;1例拔除导尿管后出现尿潴留,重新留置导尿管4周后,定期扩张尿道6个月,排尿通畅,最大尿流率15.6 mL/s;1例拔管3个月后尿道膜状狭窄,行冷刀内切开治疗后排尿通畅。结论:腹腔镜技术联合会阴小切口术式治疗后尿道狭窄可减小手术创伤,降低后尿道再狭窄发生率,手术方式安全可靠,值得推广。更多还原

【Abstract】 Objective:To investigate the efficacy and safety of laparoscopy in treating complicated posterior urethral stricture.Methods:The clinical data of 26 patients with complex posterior urethral stricture from September2014 to September 2017 were analyzed retrospectively.Results:All the 26 patients completed the operation successfully. The operation time was(160±55)min(130-230 min). The hospitalization was(7.6±1.4)d(3-11 d)after operation. The urethral catheter was removed 2 weeks after the operation. All patients were followed-up for 18 months(7-36 months)after the operation,and no case was lost. After extubation,the urination was unobstructed in 24 cases. The maximum urine flow rate was(19.0±4.6)mL/s. Urinary retention occurred in 1 case after removal of urethral catheter. After 4 weeks,the catheter was removed again and urethral dilatation was regularly performed for 6 weeks. The voiding patency rate and maximum urine flow rate were 15.6 mL/s after 6 months. One case had membranous urethral stricture 3 months after extubation. After cold-knife internal urethrotomy the urination was unobstructed.Conclusion:laparoscopy can be used of minimally invasive treatment of posterior urethral stricture safely and reliably. Combined with open surgery for posterior urethral stricture,the operation can achieve less trauma and restenosis. It is an effective measure in treating posterior urethral stricture,and could be widely used in clinical.更多还原