顺行“挂钩”法置入双J管在腹腔镜肾盂成形术中的应用

发布时间：2018-06-13 20:13

本文选题：肾盂输尿管连接部梗阻 + 肾积水　；参考：《中国微创外科杂志》2017年10期

【摘要】：目的探讨以"挂钩"的方式顺行置入双J管在腹腔镜肾盂成形术中的应用。方法 2014年10月~2016年5月对28例肾盂输尿管连接部梗阻行腹腔镜肾盂成形术,在完成肾盂输尿管连接部后壁的缝合后,双J管以"挂钩"的方式顺行置入输尿管内,双J管远端进入膀胱内,撤出导丝及推管,腹腔镜弯钳将双J管近端放置肾盂内,完成肾盂输尿管连接部的前壁缝合。结果 28例双J管均以顺行方式顺利置入,围手术期无并发症发生。镜下置管时间2 min 30 s~4 min 45 s,平均3 min 5 s。术后4~6周拔除双J管,复查泌尿系超声或静脉肾盂造影,肾积水较术前减轻(术前中度17例,重度11例;术后中度9例,轻度13例,无肾积水6例)。结论顺行"挂钩"法置入双J管安全、操作简便,利用双J管自身的优势,不需要额外辅助器械,为腹腔镜肾盂成形手术中置入双J管提供一种新的思路。
[Abstract]:Objective to investigate the application of double J tube placement in laparoscopic pyeloplasty. Methods Laparoscopic pyeloplasty was performed in 28 patients with ureteropelvic junction obstruction from October 2014 to May 2016. After the posterior wall of ureteropelvic junction was sutured, the double J tubes were placed into the ureter in a "hook" manner. The distal end of the double J tube entered into the bladder and the guide wire and push tube were withdrawn. The proximal end of the double J tube was placed in the renal pelvis by laparoscopic forceps and the anterior wall of the ureteropelvic junction was sutured. Results 28 cases of double J tube were successfully implanted in a anterograde manner, and no complications occurred in perioperative period. The tube placement time was 2 min 30 s and 4 min 45 s with an average of 3 min 5 s. After 4 weeks, double J tubes were removed and urinary tract ultrasound or intravenous pyelography were re-examined. Hydronephrosis was alleviated in 17 patients with moderate hydronephrosis before operation, 11 patients with severe hydronephrosis, 9 patients with moderate postoperative complications, 13 patients with mild hydronephrosis and 6 patients without hydronephrosis. Conclusion it is safe and convenient to put double J tube in the direct "hook" method. The advantages of double J tube are taken advantage of, and no additional auxiliary instruments are needed, which provides a new way of thinking for the placement of double J tube in laparoscopic pyeloplasty.
【作者单位】：河北医科大学第二医院泌尿外科;
【基金】：河北医科大学第二医院科学研究基金项目(项目编号:2h1201623)
【分类号】：R699.2

【相似文献】