Ngo Dai Hai, Nguyen Tuan Vinh, Vu Le Chuyen * Y hoc TP. Ho Chi
Minh * Vol. 16 - No 4- 2012: 200 - 205
Objectives: To assess the feasibility, safety and efficacy of
retroperitoneal laparoscopic dismembered pyeloplasty for treating ureteropelvic
junction (UPJ) Obstruction in children.
Materials and Methods: From May 2006 to December 2011, at Urology
Departments of Binh Dan Hospital, 96 patients with primary UPJ obstruction underwent
retroperitoneal laparoscopic pyeloplasty, in which there were 16 children. We used
laparoscopic instruments of Storz with 10mm laparoscope, 5 -10mm trocars. A three
to four - port, balloon - dissecting technique was used. The type of UPJ repair
performed was dismembered Anderson - Hynes. All anastomoses were completed intracorporally
with 4.0 Vicryl sutures. Ureteral transposition was performed as needed. The JJ
stent was removed after 4 to 6 weeks and ultrasonography, IVP or
ĐẶT VẤN ĐỀ
Diuretic renal scan were performed at 3 to 6 months or 12 months
as indicated. The outcome of 16 pediatric patients was assessed during intraoperative
and postoperative period.
Results: All laparoscopical operations were successfully completed.
Mean operating time was 123.13 minutes (90 -195). Mean estimated blood loss was
8.94 ml (3 - 30). Mean hospital stay was 5.38 days (4 - 7). A crossing vessel was
found in 4 patients (25%). No remarkable intraoperative complication occurred, There
were 9 cases of mild subcutaneous emphysema. No postoperative complications. Mean
following up period was 29.5 months (7 - 72). Fifteen patients (93,8%) Were asymptomatic
and had improved hydronephrosis on IVP or UPJ drainage in diuretic renal scan. One
patient underwent retrograde endopyelotomy due to recurrent hydronephrosis at 20
months.
Conclusions: In our condition, retroperitoneal laparoscopic dismembered
pyeloplasty is a safe and effective alternative treatment for UPJ obstruction in
children.
Key words: Ureteropelvic junction obstruction, dismembered pyeloplasty,
retroperitoneal laparoscopy.
Trong