达芬奇机器人辅助腹腔镜联合输尿管硬镜一期治疗肾盂输尿管连接部梗阻合并肾结石

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摘要 目的:探讨达芬奇机器人辅助腹腔镜联合输尿管硬镜一期治疗肾盂输尿管连接部梗阻(UPJO)合并肾结石的有效性和安全性。方法:回顾性分析14例因UPJO合并肾结石接受达芬奇机器人辅助腹腔镜联合输尿管硬镜治疗患者临床资料。结果:14例患者中,双侧UPJO 1例,左侧UPJO 6例,右侧UPJO 7例。手术时间平均180.5 min,较单纯UPJO治疗患者延长42 min;13例患者肾结石一期取净,1例患者经ESWL处理后结石自行排出,经过平均13.6个月的随访,治疗UPJO有效率达100%,失血量平均48.8 ml,平均住院6.0 d,术后有2例患者发生腹膜后暂时性漏尿,UPJO合并肾结石治疗有效率、失血量、住院日和术后并发症发生率与单纯UPJO接受达芬奇机器人辅助腹腔镜治疗患者无明显差异。结论:达芬奇机器人辅助腹腔镜联合输尿管硬镜一期治疗UPJO合并肾结石具有较高的有效性和安全性。

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	郑霁
	鄢俊安
	李为兵
	张恒
	陈志文
	周占松
	潘进洪

关键词 ：达芬奇机器人辅助手术, 肾盂输尿管连接部梗阻, 输尿管硬镜, 肾盂输尿管成型术

Abstract：Objective:We present our experience with using rigid nephroscopy for renal calculi removal during robot-assisted pyeloplasy (RAP) for UPJO. Methods:17 patients who underwent RAP for UPJO and rigid nephroscopy for renal calculi were enrolled in our study. Their medical records were analysised retrospectively. Results:UPJO were found on dual sides, the left side and the right side in 1, 6 and 7 patients respectively. The average operative time was 180.5 min, which was 40.9 minutes longer than the mean operative time in patients without renal calculi. There was no significant difference in blood loss, hospital stay, complications, and success rates between patients with and without renal calculi. Conclusions:The use of a concomitant rigid nephroscope and RAP is a safe and feasible option for the treatment of UPJO complicated with renal calculi.

Key words： da Vinci robotic surgery ureteropelvic junction obstruction rigid nephroscopy laparoscopy

收稿日期: 2014-07-13

ZTFLH:

R699

通讯作者: 潘进洪,Panjh765@hotmail.com

引用本文:

郑霁,鄢俊安,李为兵,张恒,陈志文,周占松,潘进洪. 达芬奇机器人辅助腹腔镜联合输尿管硬镜一期治疗肾盂输尿管连接部梗阻合并肾结石[J]. 微创泌尿外科杂志, 2014, 3(4): 197-200.
Zheng Ji,Yan Jun'an,Li Weibing,Zhang Heng,Chen Zhiwen,Zhou Zhansong,Pan Jinhong. Concomitant treatment of ureteropelvic junction obstruction and renal calculi with robotic laparoscopic surgery and rigid ureteroscopy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2014, 3(4): 197-200.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract876.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2014/V3/I4/197

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