首次手术失败后再行腹腔镜肾盂成形术的临床-研究

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1、浙江火学硕：b学位论文摘要4．结论本组的研究结果提示：首次的开放手术或腹腔镜手术会造成肾盂输尿管周围的粘连，给再次腹腔镜肾盂成形术带来困难，但只要腹腔镜操作技术熟练，再次腹腔镜肾盂成形术安全可行，还保持了腹腔镜手术微创的优点。经腹腔途径更容易完成手术。与国外文献结果报告相比，手术时间更短，与我们镜下分离和缝合技术熟练有关。关键词：腹腔镜；肾盂成形术；肾盂输尿管连接部VJ浙江大学硕士学位论文摘要LaparoscopicPyeloplastyinSecondaryUreteropelvicJunctionObstructionduetoFailedOpenorLaparasco

2、picSurgery．MedicalcollegeofZhejiangUniversityUrology2008gradeMasterWanLUunSupervisorZhangDahongBaekgroundandpurposeAbstractUreteropelvicjunction(UPOobstructionleadstoprogressivedilationoftherenalcollectingsystemandcallresultinpainandprogressivedeteriorationofrenalfunction．Historically，open

3、dismemberedpyeloplastyhasbeenthegold．standardtreatmentforprimary帅Jobstruction，capableofcorrectingallformsofobstructionwithSuccessrates>90％【l’2】．Overthepastdecade，laparoscopicpyeloplasty，asatechniqueofferingtheSuccessrateofopensurgerythroughaminimallyinvasiveapproach，sincereportedinitiallyb

4、ySchuesslercta1．，hasbecomeaviableoptionforthetreatmentofselectpatientswith‘primaryUPJobstruction．Moreandmoreliteratureshowedthatlaparoscopicpyeloplastyismovingrapidlytoward"replacingopensurgeryasthegoldstandardinthetreatmentofUPJobstructionp一．AlthoughSuccessratesarehigh，failuresdooccurandn

5、ecessitateadditionalinterventions．However，littlehasbeenwrittenontheapplicationofthistechniqueforsecondaryureteropelvicjunctionobstructionduetofailedopenorlaparoscopicpyeloplasty．Prioropenorlaparoscopicpyeloplastyhasbeenconsideredarelativecontraindicationtolaparoscopicsurgerybecauseofthelik

6、elihoodofadhesionformationVII浙江大学硕士学位论文摘要andperinephricscarring，whichresultsindifficultyduringsurgicaldissection．ThepurposeofthisstudywastoexaminethefeasibilityandmorbidityoflaparoscopicpyeloplastyinpatientswithsecondaryUPJOduetofailedopenorlaparoscopicpyeloplasty，Allthepatientswereoperate

7、dbyasingleskilledurologicsurgeon．MethodsBetweenSeptember2004andMay2008，11patientswithsecondaryUPJobstructionduetofailedopensurgery(9)andlaparoscopicpyeloplasty(2)whohadundergonelaparoscopicpyeloplastywereenrolledinthisstudy(groupA)。Themeanintervalfromthelastsu