Abstract：Objective: To investigate the curative effectivness of laparoscopic upper pole heminephrectomy in adult patients with the abnormalities of duplex kidney and ureter. Methods: A total of 12 patients with an age range of 28 to 53 years old underwent laparoscopic upper pole heminephrectomy between June 2010 to Jan. 2016. The key points of the technique included the placement of a catheter in the normal ureter at the beginning of the procedure. The patients were positioned in a 45-90 degrees lateral decubitus position and a 4-port transperitoneal or 3-port retroperitoneal technique was applied followed by the mobilization of the upper pole ureter away from the renal hilum. Afterwards, the vasculature supplying the upper pole was precisely ide.pngied and ligated. Followed by transection of the vasculature, the upper pole moiety was fully transected using the harmonic scalpel. Results: Nine patients were operated on using the retroperitoneal approach and 3 using the transperitoneal technique. The operation time ranged between 150 to 290 min with estimated blood loss of 90-380 mL. The patients with retroperitoneal approach had a shorter bowel movement recovery time than in those with transperitoneal approach [(53.4±16.2) vs. (62.3±12.7) h, P<0.05]. All of the patients were generally discharged on postoperative day 8.4 (range 7-10 d). There was no significant complication during the surgery with quick recovery after the surgery. Conclusions: Laparoscopic upper pole heminephrectomy for an ectopic ureter is safe and reproducible. Retroperitoneal approach can significantly reduce the risk of intra-abdominal organ injury and shorter bowel movement recovery time, with less dissection to reach the renal pedicle and a cosmetic result.
柯为, 葛成国, 徐光勇, 姜庆, 张唯力, 刘川, 梁培禾, 杨小军, 罗旭. 腹腔镜上半肾切除术治疗成人重复肾输尿管畸形[J]. 微创泌尿外科杂志, 2018, 7(4): 235-240.
Ke Wei, Ge Chengguo, Xu Guangyong, Jiang Qing, Zhang Weili, Liu Chuan, Liang Peihe, Yang Xiaojun, Luo Xu. Laparoscopic upper pole heminephrectomy in adults for treatment of abnormalities of duplex kidney and ureter. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(4): 235-240.
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