腹腔镜治疗儿童异位肾伴其他泌尿系统畸形9例

Laparoscopic treatment of ectopic kidney with other urinary malformations in 9 children

摘要:

目的：探讨儿童异位肾伴其他泌尿系统畸形的临床特点与治疗方法，评估腹腔镜手术的安全性及有效性。方法：回顾性分析重庆医科大学附属儿童医院泌尿外科2009年10月至2018年7月收治异位肾伴其他泌尿系统畸形并行腹腔镜手术治疗9例患儿的临床资料。结果：儿童异位肾常合并其他泌尿系统畸形：同侧肾发育不良（6/9）、同侧肾盂输尿管连接处狭窄（3/9）、同侧输尿管开口异位（5/9）、尿道阴道瘘（2/9），6例行腹腔镜下发育不良肾及输尿管切除术，3例行腹腔镜下离断式肾盂成形术，手术顺利，无中转开腹病例，所有病例术前症状均有改善，随访肾积水无复发。结论：异位肾常伴其他泌尿系统畸形，采用腹腔镜技术治疗创伤小、安全、效果好。

Abstract:

Objective：To investigate the clinical features and treatment of ectopic kidney with other urinary malformations in children，and to assess the safety and effectiveness of laparoscopic treatment. Methods：The clinical data of 9 children with ectopic kidney and other urinary malformations treated with laparoscopy from October 2009 to July 2018 in Department of Urology，Children’s Hospital of Chongqing Medical University were retrospectively analyzed. Results：Ectopic kidney often occurred with other urinary malformations in children，including ipsilateral renal dysplasia（6/9），ipsilateral ureteropelvic junction stenosis（3/9），ipsilateral ectopic ureteral orifice（5/9），and urethrovaginal fistula（2/9）. Six children underwent heminephrectomy and nephroureterectomy and 3 children under－went dismembered pyeloplasty by laparoscopy. The operations were successful without conversion to open surgery. All children showed a postoperative improvement in preoperative symptoms and follow-up showed no recurrence of hydronephrosis. Conclusion：Ectopic kidney often occurs with other urinary malformations in children and it is minimally invasive，safe，and effective to treat this disease with laparoscopy.