【摘要】 目的探讨腹腔镜肾折叠减容手术治疗巨大肾积水的可行性及初步临床经验。方法采用腹腔镜肾折叠减容手术治疗巨大肾积水5例。通过腹腔镜下解除上尿路梗阻并于镜下用2-0可吸收线“8”字缝合肾皮质,将肾脏中盏缝至上盏、下盏缝至中盏,将其折叠为拳头大小,并缝合肾周筋膜。结果5例手术均取得成功。手术时间75~160min,平均(134.27±32.12)min。术中出血约50~200ml,平均(124.33±11.34)ml。术后1~3d肛门排气,平均(2.18±0.46)d,1~3d拔除腹腔引流管,1周拔除导尿管并出院。术后1个月于膀胱镜下拔除双J管,无尿漏,随访3~18月,平均(14.62±3.83)月,无输尿管狭窄。静脉尿路造影及腹部超声复查显示患肾积水明显减轻。ECT检查术侧肾脏肾小球滤过率好转。结论腹腔镜肾折叠减容手术是巨大肾积水保肾手术的微创途径,可以促进肾形态和肾功能的恢复。更多还原

【Abstract】 Objective To explore the experience of transperitoneal laparoscopic renal plication for giant hydronephrosis and to evaluate operation feasibility.Methods Five cases of giant hydropyrosis including 1 upper ureter calculus,1 ureteropelvic junction(UPJ) obstruction, 2 middle ureter calculus and 2 nephrolithiasis were relieved upper urinary tract obstruction and performed plication via laparoscope. Results All cases were successful and blood loss were 50～200 ml(124.33±11.34), surgical time were 75～160 min(134.27±32.12). Following up 3～ 18 months(14.62±3.83), all cases of hydronephrosis and renal function were getting better than that of preoperation. Conclusion Laparoscopic renal plication is an effective and minimal invasive method to treat giant hydronephrosis.更多还原