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目的:探讨经后腹腔单切口腹腔镜技术行离断式肾盂成形手术的临床效果和技术方法。方法:采用单切口腹腔镜技术经后腹腔对2例确诊为肾盂输尿管连接部(UPJ)狭窄的患者实施离断式肾盂成形术(dismemberedanderson-hynes pyeloplasty),采用腰部腋中线切口,长约2.5 cm,置入自制的单切口Port,手术过程分别使用Cambridge endo可弯单通道腹腔镜器械、超声刀、普通持针器、普通腹腔镜器械等。结果:2例手术均获得成功,未中转开发手术,亦未增加皮肤切口,手术时间分别为230 min、160 min,术中出血60 ml、40 ml,术后住院时间均为6天,无围手术期并发症。术后6周拔除双J管并复查B超、IVU,肾积水明显减轻,吻合口无狭窄。结论:经后腹腔单切口腹腔镜肾盂成形术作为一种新兴技术治疗肾盂输尿管连接部狭窄是安全可行的,具有创伤更小、美容效果更好的特点。随着单孔腹腔镜器械以及腹腔镜技术的不断提高,这项技术值得在临床上推广应用。
Objective: To investigate the clinical effect and technical method of trans-abdominal single-incision laparoscopy in the segmental pyeloplasty. METHODS: Two patients with UPJ stenosis underwent retroperitoneal laparoscopy via a retroperitoneal approach to perform dismemberedanderson-hynes pyeloplasty. The midline incision of the midline of the waist was used and the length was about 2.5 cm , Into a single-incision made Port, surgical procedures were used single end lacrimal canal endo bend flexible instruments, ultrasonic knife, ordinary needle holder, laparoscopic instruments and so on. Results: All of the two surgeries were successful. No operation was transferred to the patients. No skin incision was made. The operative time was 230 min and 160 min respectively. The intraoperative bleeding was 60 ml and 40 ml. The postoperative hospital stay was 6 days. Surgical complications. Six weeks after the removal of double J tube and review B ultrasound, IVU, hydronephrosis was significantly reduced, anastomotic stenosis. Conclusions: Transabdominal single-incision laparoscopic pyeloplasty as an emerging technique for the treatment of ureteropelvic junction stenosis is safe and feasible with less trauma and better cosmetic results. With the single-hole laparoscopic instruments and laparoscopic technology continues to improve, the technology worthy of clinical application.