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目的探讨后腹腔镜输尿管成形术治疗腔静脉后输尿管的手术方法及疗效。方法收治腔静脉后输尿管患者15例,15例患者均行后腹腔镜输尿管成形术,其中2例应用3D腹腔镜技术完成。结果 15例手术时间100-130min,平均110min。术中出血量20-50ml,平均35ml。患者术后4-10d,平均7d出院。术后4-6周拔除双J管。术后随访6-20个月,复查B超或IVP提示右输尿管无梗阻,右肾积水程度较术前明显减轻,吻合口无狭窄。结论在腹腔镜技术熟练的基础上,对此类患者行后腹腔镜输尿管成形术,具有创伤小、恢复快、手术安全性高、效果好的优点,可作为治疗该病的首选方法。新近问世的3D腹腔镜技术,在空间定位及深度感觉上有明显的优势,一定程度上降低手术难度,是一项值得推广的新技术。
Objective To investigate the surgical method and efficacy of retroperitoneal laparoscopic ureteroplasty for the treatment of ureter after vena cava. Methods Fifteen cases of ureter after vena cava were treated, and 15 cases underwent retroperitoneal laparoscopic ureteroplasty. Two cases were completed by 3D laparoscopy. Results 15 cases of operation time 100-130min, an average of 110min. Intraoperative bleeding 20-50ml, an average of 35ml. Patients after 4-10d, an average of 7d discharged. 4-6 weeks after removal of double J tube. Postoperative follow-up 6-20 months, review B or IVP prompted right ureter without obstruction, right kidney hydronephrosis significantly reduced compared with preoperative, anastomotic without stenosis. Conclusions Laparoscopic ureteroplasty is the first choice of laparoscopic ureteroplasty in this kind of patients based on the proficiency of laparoscopy. It has the advantages of small trauma, fast recovery, high operative safety and good effect. The newly introduced 3D laparoscopic technique has obvious advantages in spatial positioning and depth perception, and to a certain extent, reduces the difficulty of surgery. It is a new technology worthy of promotion.