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目的探讨机器人辅助腹腔镜肾盂成型术与输尿管软镜杂交手术治疗合并肾结石的复杂肾盂输尿管连接部梗阻(UPJO)的可行性。方法回顾分析我科于2012年5月至2013年8月收治的5例UPJO合并肾结石患者的临床资料,其中单发肾下极结石3例,多发结石2例。所有患者均采用机器人辅助腹腔镜肾盂成型术联合输尿管软镜取石杂交手术治疗。结果 5例均顺利完成手术,无严重手术并发症,实际手术时间平均(132.4±24.8)min,平均软镜取石时间(25.4±11.9)min,软镜均能完整探查肾脏集合系统,术后复查提示结石取净率达100%。术后随访6个月,所有患者不适症状均明显减轻,仅1例患者仍有2cm肾积水,其余4例UPJ成型效果满意。结论机器人辅助腹腔镜与输尿管软镜杂交手术治疗合并肾结石的复杂性UPJO安全可行。
Objective To investigate the feasibility of robotic-assisted laparoscopic pyeloplasty and ureteroscopic hybridization in the treatment of complex renal pelvis and ureteropelvic junction obstruction (UPJO). Methods The clinical data of 5 patients with UPJO combined with renal calculus admitted to our department from May 2012 to August 2013 were retrospectively analyzed. Among them, 3 cases were single ankle under the kidney and 2 were multiple stones. All patients were treated with robot-assisted laparoscopic pyeloplasty and ureteroscopic hybridization. Results All the 5 cases were successfully performed without serious complications. The average operation time was (132.4 ± 24.8) min and the average time of taking the soft lens was (25.4 ± 11.9) min. The soft lens could completely detect the renal collecting system. After the operation, Tip stone take rate of 100%. All cases were followed up for 6 months. The symptoms of all patients were significantly relieved. Only 1 patient had 2 cm hydronephrosis and the remaining 4 patients were satisfied with the results of UPJ. Conclusions The robot assisted laparoscopic and ureteroscopic hybrid surgery in the treatment of complicated renal stones with UPJO is safe and feasible.