Clinical analysis of modified laparoscopic dismembered pyeloplasty in children with ureteropelvic junction obstruction
10.3760/cma.j.issn.1000-6702.2014.08.008
- VernacularTitle:改良腹腔镜下离断式肾盂成形术治疗小儿肾盂输尿管连接处梗阻的临床分析
- Author:
Zhishang NIU
;
Chunsheng HAO
;
Hui YE
;
Dongsheng BAI
;
Long LI
;
Jinqiu SONG
;
Ying QIU
- Publication Type:Journal Article
- Keywords:
Hydronephrosis;
Laparoscopy;
Children;
Double hitch;
Double-J stent
- From:
Chinese Journal of Urology
2014;35(8):587-590
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic effect of modified transperitoneal laparoscopic dismembered pyeloplasty in children with with ureteropelvic junction obstruction (UPJO).Methods The clinical data of 27 children with UPJO treated with transperitoneal laparoscopic dismembered pyeloplasty were analyzed retrospectively.The age ranged from 5 to 104 months (mean,37 months).All cases were diagnosed by ultrasonography,IVU,CT and/or renal radionuclide scanning.The antero-posterior pelvic diameter was more than 3 cm by ultrasound in all cases.Indications of surgery were as followings:symptoms of upper abdominal pain or low back pain and/or split renal function ＜40％ and/or progressive dilatation.Modified transperitoneal laparoscopic dismembered pyeloplasty was performed.Double hitch stitches were transfixed at the top of pelvis and ureter to be anastomosed,and a 6 F urethral catheter was inserted as a ureteral stent percutaneously through the puncture hole and was removed 7-9 days postoperatively without double-J stent.Results All operations were completed laparoscopically without conversion to open surgery.The mean operative time was 118 min (range,85 to 176),the mean blood loss was 16 ml (range,10 to 30) and the mean postoperative hospital stay was 10.5 days (range 9 to 13).The perinephric urine drainage occurred in 2 patients with about 200 ml/d,and reduced to 6 ml/d and 4 ml/d 5 to 6 days after operation.During the follow-up period for 12 to 36 months(mean,22 months) in 27 cases,there was no stricture at UPJ and the hydronephrosis reduced significantly or disappeared.Conclusion Laparoscopic dismembered pyeloplasty with double hitch stitches and an ordinary urethral catheter as an ureteral stent is an easy method with high successful rate and less operative time,which avoids reoperation to remove the double-J stent and is worthy of clinical popularization.
