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在机器人辅助的 laparoscopic pyeloplasty 中重新定位泌尿外皮交叉点

Leon Chertin¹, Avigal Lask¹, Andrew Shumaker²

¹Department of Urology, Shamir Medical Center, Zerifin, Israel; Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

|November 3, 2023

概括

机器人辅助的皮叶整形与尿路皮层连接 (UPJ) 重定位为复杂的病例提供了可行的替代方案. 这种修改后的技术表现出与标准安德森-海恩斯手术相比的成功率,在特定的解剖学情况下可能有好处.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
最少侵入性的手术
儿科手术儿科手术

背景情况:

泌尿外皮结 (UPJ) 阻塞是儿童和成人水性的常见原因.
机器人辅助腹腔镜整形已经成为UPJ阻塞的首选手术方法.
标准的安德森-海恩斯 (AH) 切碎型肌切除术是已确定的技术,但可能会面临低于最佳的UPJ解剖学的挑战.

研究的目的:

描述和评估一项在机器人辅助切割皮质整形过程中修改UPJ重新定位的技术.
为了比较UPJ重新定位与经典AH皮叶造形手术的外科和术后结果.

主要方法:

70例机器人辅助腹腔镜整形术病例 (2016-2022) 的回顾性审查.
15名患者接受了UPJ重新定位,而55名患者进行了经典的AH皮叶造形术.
人口统计数据,手术时间和手术后的结果在各组之间进行了比较.

主要成果:

对UPJ重新定位的指示包括高UPJ插入,血管交叉和脏形.
两组人都在胎儿泌尿学会的分类和分裂功能中显著改善.
重定位组有1次失败 (6.6%) 与AH组中的3次失败 (5.5%),没有显著差异 (P > .05).
在重新定位组中发生的Clavien-Dindo 3 级并发症较少.

结论:

UPJ重新定位是一种有价值的可选技术,用于机器人辅助的皮叶整形,当UPJ处于不理想的解剖位置时.
这种修改后的方法证明了与标准AH技术相比的有效性和安全性.
它在具有挑战性的解剖结构中促进了解剖结合,从而有可能改善结果.

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