腹腔镜和机器人辅助回肠代输尿管术在临床应用中的可行性和治疗效果（英文）

Mishra Prashant; 李炯明

腹腔镜和机器人辅助回肠代输尿管术在临床应用中的可行性和治疗效果（英文）

昆明医科大学第二附属医院泌尿外科

基金项目:

基金：昆明医科大学重大成果培育项目 (CGPY201404);

计量
- 文章访问数: 1976
- HTML全文浏览量: 720
- PDF下载量: 64
- 被引次数: 0
出版历程
- 收稿日期: 2017-09-10

Application of Laparoscopic and Robotic Ileal Uureteral Replacement Feasibility and Clinical Efficacy

Funds:

基金：昆明医科大学重大成果培育项目 (CGPY201404);

摘要

摘要: 回肠代输尿管术是治疗患者长段输尿管狭窄的恰当方式.微创手术技术已被证明和开放手术具有相同的安全性, 且在减少手术创伤、出血和术后康复周期方面明显优于开放手术.为了研究腹腔镜下回肠代输尿管术的可行性和临床疗效, 对相关文献中该手术方案的手术指征、禁忌症、手术方法和术后结果进行了综述, 并结合昆明医科大学第二附属医院对该手术的实践经验进行综合分析.共有20例腹腔镜下回肠代输尿管术报道纳入综述, 其手术时间在195～480 min之间, 出血量在50～375 mL之间;共有7例机器人辅助的回肠代输尿管术报道纳入综述, 其手术时长在320～720 min之间, 出血量少于10～100 mL.该手术的并发症包括腹腔内尿瘘、小肠梗阻、吻合口瘘、暂时性氮质血症和泌尿系感染等.术后所有患者的肾功能都得到不同程度恢复.综上, 腹腔镜或机器人辅助回肠代输尿管术是治疗长段输尿管狭窄的一种可行且有效的手术方案, 尽管其疗效和传统开放手术相当, 但腹腔镜和机器人辅助方法因其微创特点仍具有相对优势, 它们均可有效降低手术创伤、术中出血量、术后并发症、手术瘢痕形成和术后康复时间.由于现有报道的病例数量有限, 故还需对回肠代输尿管的微创手术方案进行更多和长期的研究, 以便建立和完善该术式的标准手术步骤和手术技巧.
- 长段输尿管损伤 /
- 腹腔镜 /
- 机器人辅助 /
- 回肠代输尿管术 /
- 临床疗效
Abstract: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of lesser trauma, less bleeding and less postoperative recovery time. In order to evaluate the feasibility and clinical efficacy of laparoscopic ileal ureter replacement, review of related literatures, indications, contraindications, surgical method, postoperative results combined with experience of our center has been done. Total 20 cases of laparoscopic ileal ureteral operation have been reviewed, the mean operation time was 195480 and blood loss was 50 ~ 375 ml and 7 Robotic ileal ureter replacement were reviewed median surgery time was 320720 min and bleeding is less then 10 ml100 ml. The operation complications include urinary leakage, intestinal obstruction, anastomotic site leakage, transient azotemia, urinary tract infection and so on. Postoperative renal function of all patients was improved in different degrees. Laparoscopic and Robotic ileal ureter replacement is feasible and can be used as an effective treatment for long ureteral injuries, although the curative effect is same as that of traditional open surgery, but Comparatively laparoscopic and robotic postoperative morbidity is less and have advantages such as it reduces surgical trauma, intraoperative bleeding, postoperative complications, less surgical scar and recovery time.The cases in the reports are limited, more cases need to be studied, and long-term results need to be assessed to establish and standardize these technique.
- Long segment ureter injury /
- Laparoscopic /
- Robotic /
- Ileal ureter replacement /
- Clinical efficacy

HTML全文

参考文献(29)

[1]	[1]RUTIGLIANO D N, GEORGES A, WOLDEN S L, et al.Ureteral reconstruction for retroperitoneal tumors in children[J].J Pediatr Surg, 2007, 42 (2) :355-358
[2]	[2]VAGLIO A, SALVARANI C, BUZIO C.Retroperitoneal fibrosis[J].Lancet, 2006, 367 (9506) :241-251.
[3]	[3]BALTACI S, OZER G, OZER E, et al.Failure of ureteral replacement with Gore-Tex tube grafts[J].Urology, 1998, 51 (3) :400-403.
[4]	[4]CHUNG B I, HAMAWY K J, ZINMAN L N, , et al.The use of bowel for ureteral replacement for complex ureteral re-construction:long-term results[J].J Urol, 2006, 175 (1) :179-183.
[5]	[5]MATTOS R M, SMITH J J, LIBERTINO J A.Conservative surgery for ureteral tumor associated with horseshoe kidney[J].J Urol, 158 (5) :1701-1997.
[6]	[6]GILL I S, SAVAGE S J, SENAGORE A J, et al..Laparoscopic ileal ureter[J].J Urol, 2000, 163 (4) :1199-1202.
[7]	[7]STEIN R J, TURNA B, PATEL N S, et al.Laparoscopic assisted ileal ureter:technique, outcomes and comparism to open procedure[J].J Urol, 2009, 182 (3) :1032-1039.
[8]	[8]ABRAMS H J, BUCHBINDER M I.Experience with ileal ureters[J].Bulle n of The New York Academy of Medicine, 1977, 53 (4) :329-337.
[9]	[9]ARMATYS S A, MELLON M J, BECK S D W, et al.Use of ileum as ureteral replacemnet in urological recostruc on[J].J Urol, 2009, 181 (1) :177-181.
[10]	[10]BAUM WC.The clinical use of terminal ileum as a substitute ureter[J].JUrol, 1954, 72 (1) :16-33.
[11]	[11]WILLARD E, GOODWIN.Replacement of the ureter by small intestine:clinical application and results of the ilealureter[J].JUrol, 1959, 81 (3) :406-418.
[12] 徐学禧.回肠段代替部分输尿管手术的介绍[J].中华外科杂志, 1957, 7 (3) :590.
[13]	[13]MATLAGA B R, SHAH O D, HART L J, et al.Ileal ureter substitution:a contemporary series[J].Urology, 2003, 62 (6) :998-1001.
[14]	[14]KAMATNN, KHANDELWAL P.Laparoscopy-assisted ileal ureter creation for multiple tuberculous strictures:report of two cases[J].J Endourol, 2006, 20 (6) :388.
[15]	[15]KAMAT N N, KHANDELWAL P.Laparoscopy-assisted reconstruction of a long-segment ureteral stricture usingreconfigured ileal segment:Application of the Yang Monti principle[J].J Endourol, 2007, 21 (12) :1455-1460.
[16]	[16]CASTILLO O A, SANCHEZ-SALAS R.Laparoscopyassisted ureter interposition by ileum[J].J Endourol, 2008, 22 (4) :687-692.
[17]	[17]DESAI M M, STEIN R.Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) foradvanced reconstruction:initial experience[J].Urology, 2009, 73 (1) :182-187.
[18]	[18]SIM A, TODENH FER T.Intracorporeal ileal ureter replacement using laparoscopy and robotics[J].Cent European J Urol, 2014, 67 (4) :420-423.
[19]	[19]RAMALINGAM M, SENTHIL K, MURUGESAN A, et al..Laparoscopy assisted'U'configuration bilateral ileal ureter in pelvic lipomatosis with bilateral uretericobstruction[J].Urol J, 2013, 10 (3) :1007-1010.
[20]	[20]SHAILESH P, PUNTAMBEKAR, SANJAY KUMAR, et al.Laparoscopic ileal ureter:A completely intracorporeal technique[J].J Cases Obstet Gynecol, 2014, 1 (3) :32-35.
[21]	[21]WAGNER J R, SCHIMPF M O, COHEN J L.Robotassisted laparoscopic ileal ureter[J].JSLS, 2008, 12 (3) :306-309.
[22]	[22]BRANDAO L F, AUTORINO R, et al.Robotic ileal ureter:a completely intracorporeal technique[J].Urology, 2014, 83 (4) :951-954.
[23]	[23]CHOPRA S, METCALFE C.Initial series of four arm robotic completely intracorporeal Ileal ureter[J].J Endourol, 2016, 30 (4) :395-399.
[24]	[24]KOENIG J F, RENSING A.First-ever reported obstructing ureteral nephrogenic adenoma in a child and subsequent robotic-assisted laparoscopic Ileal ureter[J].Urology, 2016, 94:221-223.
[25]	[25]RAUL ORDORICA, LUCAS R, WIEGAND, et al.Ureteral replacement and onlay repair with reconfigured intestinal segments[J].J Urol, 2014, 191 (5) :1301-1306
[26]	[26]MATTOSRM.Ilealureter[J].Urol Clin North Am, 1997, 24 (4) :813-825.
[27]	[27]KOMNINOS C, KOO K C, RHA K H.Laparoendoscopic management of midureteral strictures[J].Korean J Urol, 2014, 55 (1) :2-8.
[28]	[28]BOXER R J, FRITZSCHE P, SKINNER D G, et al.Replacement of the ureter by small intestine:clinical application and results of the ileal ureter in 89 patients[J].JUrol, 1979, 121 (6) :728-731.
[29]	[29]VERDUYCKT F J, HEESAKKERS J P, DEBRUYNE FM.Long-term results of ileum interposition for ureteral obstruction[J].Eur Urol, 2002, 42 (2) :181-187.

相关文章(20)

[1]	张洪波, 李振龙, 吕瑛, 张益绰, 裘翔铭, 黄婷婷. 单孔与双孔电视胸腔镜肺叶切除术治疗肺癌的临床疗效比较, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240419
[2]	张权昌, 吴乔联, 刘宇, 赵欣. 腹腔镜与开腹完全结肠系膜切除术对结肠癌患者血小板活化、并发症发生率及肿瘤复发的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230919
[3]	熊波涵, 秦艺华, 宁梓文, 王旭, 施政良, 卢晓君, 张瑶璋, 王坤. 腕关节镜下单通道腕管松解术治疗腕管综合征疗效分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20221019
[4]	冯子豪. 腹腔镜手术联合地塞米松术腔冲洗治疗子宫内膜异位症的疗效观察, 昆明医科大学学报.
[5]	姜云艳. 腹腔镜与开腹手术治疗宫颈癌的临床护理体会, 昆明医科大学学报.
[6]	黄杰, 肖民辉, 余闫宏, 张德清. 腹腔镜下输尿管切开取石术98例临床分析, 昆明医科大学学报.
[7]	罗礼君. 经脐单孔腹腔镜胆囊切除术的临床对照研究, 昆明医科大学学报.
[8]	李文亮. 腹腔镜下腹直肌前鞘子宫固定术治疗子宫脱垂的临床分析, 昆明医科大学学报.
[9]	余韬. 腹腔镜手术联合内异消癥汤治疗子宫内膜异位症不孕疗效观察, 昆明医科大学学报.
[10]	骆聪. 腹腔镜胆道镜微创保胆取石术112例临床分析, 昆明医科大学学报.
[11]	李涓. 应用宫腹腔镜切除术治疗子宫纵隔53例妊娠临床分析, 昆明医科大学学报.
[12]	马原. 腹腔镜下宫颈癌根治术治疗宫颈癌的临床分析, 昆明医科大学学报.
[13]	李双喜. 腹腔镜甲状腺次全切除术52例临床疗效观察, 昆明医科大学学报.
[14]	肖仲贤. 腹腔镜肝切除术7 例临床体会, 昆明医科大学学报.
[15]	郭姝婧. 腹腔镜腹股沟疝无张力修补术56例临床体会, 昆明医科大学学报.
[16]	王英. 腹腔镜全子宫切除术的临床应用, 昆明医科大学学报.
[17]	王健. 后腹腔镜下离断式肾盂成形术13例临床体会, 昆明医科大学学报.
[18]	杨保祥. 采用常规器械经脐单孔腹腔镜胆囊切除术64例临床分析, 昆明医科大学学报.
[19]	马锦霞. 腹腔镜与开腹手术治疗卵巢囊肿的临床比较, 昆明医科大学学报.
[20]	. 腹腔镜直肠癌手术20例临床体会, 昆明医科大学学报.