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目的探讨经腹膜后途径行腹腔镜输尿管成形术治疗下腔静脉后输尿管畸形的方法与疗效。方法 4例下腔静脉后输尿管患者均行腹膜后腹腔镜输尿管成形术,于扩张输尿管下端离断输尿管,移至腔静脉腹侧端端吻合,恢复正常解剖结构。结果 4例手术均成功,平均手术时间170(120~200)min,腹腔镜操作平均时间为150(105~180)min。无下腔静脉等邻近器官损伤,术中无明显出血,术后无漏尿发生,腰痛消失,3个月后复查示肾及输尿管上段积水扩张显著减轻,肾功能良好,吻合口无狭窄。结论经腹膜后腹腔镜输尿管成形术具有创伤小、疼痛轻、术后恢复快的优点,是治疗腔静脉后输尿管合并肾积水的首选方法 。
Objective To investigate the method and efficacy of retroperitoneal laparoscopic ureteroplasty in the treatment of ureterocele after inferior vena cava. Methods Four cases of retroperitoneal ureter underwent retroperitoneal laparoscopic ureteroplasty. The ureter was disconnected from the ureter at the lower extremity of the ureter and anastomosed to the ventral end of the vena cava to restore normal anatomy. Results All the four cases were successful. The average operation time was 170 (120-200) min and the laparoscopic operation time was 150 (105-180) min. No inferior vena cava and other adjacent organs were injured. There was no obvious bleeding during operation. No leakage occurred and no back pain occurred. After 3 months, renal and ureteral enlargement were significantly relieved. Renal function was good and anastomotic stenosis was not found. Conclusions Retroperitoneal laparoscopic ureteroplasty has the advantages of less trauma, less pain and quick recovery after operation. It is the first choice for the treatment of ureter with hydronephrosis after vena cava.