Bilateral dismembered laparoscopic pediatric pyeloplasty via a transperitoneal 4-port approach.
Bilateral dismembered laparoscopic pediatric pyeloplasty via a transperitoneal 4-port approach.
复制标题
通过经腹膜四端口方法进行双侧肢解腹腔镜小儿肾盂成形术。
DOI：
10.1097/01.ju.0000169131.58188.1f
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
P. Casale
中科院分区：
文献类型：
--
作者：
C. Schwab;P. Casale
目的
腹腔镜肾盂成形术在治疗小儿肾盂输尿管连接部梗阻中越来越被接受，其成功率接近传统开放性肾盂成形术。我们报告我们的技术，经腹膜4孔方法和定位方法，允许双侧腹腔镜离断肾盂成形术与1个不间断的无菌区。
材料和方法
两名儿童被诊断为双侧肾盂输尿管连接部梗阻。膀胱镜输尿管支架置入术后，通过将静脉压力输注袋置于患者两侧下方并将手术台旋转至侧卧位，实现手术定位。采用四孔经腹膜入路，间断6- 0聚乳糖缝线进行双侧离断肾盂成形术。
结果
两名患者的双侧交叉血管均到达肾脏下极。8岁和14岁儿童的总手术时间分别为268分钟和284分钟。分别于术后6周和8周在镇静状态下取出输尿管支架管。
结论
双侧腹腔镜肾盂成形术似乎是可行的儿科患者。
PURPOSE
Laparoscopic pyeloplasty is gaining acceptance for the treatment of ureteropelvic junction obstruction in the pediatric population, with success rates approaching those of traditional open pyeloplasty. We report our technique with a transperitoneal 4-port approach and positioning method, allowing bilateral laparoscopic dismembered pyeloplasty with 1 uninterrupted sterile field.
MATERIALS AND METHODS
Two children were diagnosed with bilateral ureteropelvic junction obstruction. Following cystoscopic ureteral stent placement operative positioning was achieved with intravenous pressure infuser bags placed under each side of the patient and rotation of the table to a lateral decubitus position. Four-port transperitoneal access was used to perform bilateral dismembered pyeloplasty with interrupted 6-zero polyglactin sutures.
RESULTS
Both patients had bilateral crossing vessels to the lower pole of the kidneys. Total operative time was 268 minutes and 284 minutes for the 8-year-old and the 14-year-old, respectively. The ureteral stents were removed separately at 6 and 8 weeks after repair with the patients under sedation.
CONCLUSIONS
Bilateral laparoscopic pyeloplasty appears feasible for the pediatric patient.