腹腔镜聚丙烯网带十二肋固定术治疗症状性肾下垂的初步经验

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摘要目的:探讨腹腔镜聚丙烯(polypropylene)网带十二肋固定术治疗症状性肾下垂的可行性和疗效。方法:2009年12月以来对4例行立卧位IVU或CT检查确诊为肾下垂患者行后腹腔镜下游离肾脏,采用自行修剪聚丙烯网片呈U型包裹肾脏下极,并用专用钉针将网片两端对合固定于十二肋。结果:4例手术均获成功,无中转开放。手术时间45~100 min,平均70 min。术中术后无并发症发生。随访3~18个月,术后1个月所有患者腰部酸痛症状较术前明显缓解。术前伴有肉眼血尿和反复出现尿路感染的患者,术后症状消失。术后复查IVU均提示患肾复位固定良好。结论:腹腔镜下聚丙烯网带十二肋固定术治疗症状性肾下垂技术可行,安全有效,并发症少,操作简单,疗效确切,是治疗症状性肾下垂的有效术式,值得推广。

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	肖恒军
	高新
	庞俊
	温星桥
	司徒杰
	李辽源
	狄金明
	邱剑光

关键词 ：肾下垂, 肾固定, 聚丙烯网带

Abstract：Objective:To present our initial experience of retroperitoneoscopic nephropexy for symptomatic nephrotosis using polyprolene mesh for fixation technique.Methods:Four patients (3 female, 1 male,21 to 36 years old)previously diagnosed with symptomatic nephrotosis underwent by means of retroperitoneoscopic nephropexy using polyprolene mesh for fixation of the kidney between December 2009 and May 2012. Each case of nephropexy was confirmed by intravenous urographyin supine and upright positions or CT scan. The kidney was mobilized retroperitoneoscopically, and fixed to the twelfth with a nonabsorbable polyprolene mesh placed in the lower 1/3 part of the kidney.Results:Retroperitoneoscopic nephropexy was successfully performed with no intraoperative complications in all patients. The mean operative time was 70 minutes (range 45-100 min). The median blood loss was less than 50 ml. In all cases pain was relieved in one month after operation. All patients reported a symptomatic improvement during follow-up (range 3-18 month).Postoperative IVU correctly confirmed a fixed kidney.Conclusions:Retroperitoneoscopic nephropexy using polyprolene mesh for fixation of the kidney to the twelfth rib is a minimally invasive, clinically established procedure.It would be a promising option for managing symptomatic nephroptosis with good clinical outcomes.

Key words： nephroptosis nephropexy polyprolene mesh

收稿日期: 2012-09-22

ZTFLH:

R692

通讯作者: 高新, gaoxin44@vip.163.com

引用本文:

肖恒军, 高新, 庞俊, 温星桥, 司徒杰, 李辽源, 狄金明, 邱剑光. 腹腔镜聚丙烯网带十二肋固定术治疗症状性肾下垂的初步经验[J]. 微创泌尿外科杂志, 2012, 1(1): 64-66.
Xiao Hengjun, Gao Xin, Pang Jun, Wen Xingqiao, Situ Jie, Li Liaoyuan, Di Jinming, Qiu Jianguang. A novel laparoscopic nephropexy technique for symptomatic nephrotosis: fixing the kidney to the twelfth rib by using polyprolene mesh. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2012, 1(1): 64-66.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract968.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2012/V1/I1/64

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