A preliminary experience of laparoscopic pyeloplasty combined with flexible ureteroscopy for the treatment of ureteropelvie junction obstruction complicated with nephrolithiasis in children at one stage
Ma Lifei1, Zhou Huixia1, Chen Shaojun1, Zhou Xiaoguang1, Liu Dehong1, Cao Hualin1, Tao Tian1, Luo Xiaolong1, Xiong Xianghua1
1Department of Urology, Bayi Children's Hospital Affiliated to the PLA Army General Hospital, Beijing 100700, China
Abstract：Objective: To evaluate the efficacy and feasibility of laparoscopic pyeloplasty (LP) combined with nephrolithotomy associated flexible ureteroscopy (f-URS) for treatment of ureteropelvie junction obstruction (UPJO) with nephrolithiasis in children at one stage. Methods: The clinical data of 8 patients who underwent LP and f-URS for UPJO with renal stones were retrospectively summarized from January 2013 to January 2016. There were 6 males and 2 females, 5 cases of left sides and 3 cases of right sides, and all cases were unilateral. The average age was 4.5 years (3-10 years). The diagnosis of UPJO complicated with nephrolithiasis was made by ultrasonography, intravenous pyelogram (IVP), magnetic resonance urography (MRU). All patients were treated by laparoscopic pyeloplasty combined with fiberscope nephrolithotomy at one stage. The pelvis was exposed under laparoscopic procedure, fiberscope was taken into the opened pelvis through one trocar, and holmium laser litholapaxy was performed. Then laparoscopic pyeloplasty was performed. Results: All operations were successful, and there was no transfer to open operation. The average operation time was 98 min (85-130 min), and the average bleeding was 15 mL (10-30 mL). During the postoperative follow-up period of 3-6 months, reexaminations of renal ultrasonography and KUB revealed that hydronephrosis regressed, the thickness of renal parenchyma increased, the stones in the pelvis and calyx were fully removed, and split renal function improved. Conclusions: The operation of laparoscopic pyeloplasty combined with fiberscope nephrolithotomy at one stage is feasible, safe, minimally invasive and scarless. We propose that laparoscopic pyeloplasty combined with fiberscope nephrolithotomy is potentially a viable treatment option for children with UPJO complicated with nephrolithiasis.
马立飞, 周辉霞, 陈绍君, 周晓光, 刘德鸿, 曹华林, 陶天, 罗小龙, 熊祥华. 腹腔镜联合输尿管软镜一期治疗小儿肾积水并发复杂肾结石的初步研究[J]. 微创泌尿外科杂志, 2018, 7(1): 14-18.
Ma Lifei, Zhou Huixia, Chen Shaojun, Zhou Xiaoguang, Liu Dehong, Cao Hualin, Tao Tian, Luo Xiaolong, Xiong Xianghua. A preliminary experience of laparoscopic pyeloplasty combined with flexible ureteroscopy for the treatment of ureteropelvie junction obstruction complicated with nephrolithiasis in children at one stage. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(1): 14-18.
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