儿童盆腔输尿管连接处梗阻的后腹膜镜血管结术-南安普顿经验。

IF 1.1 4区 医学 Q3 SURGERY
Rosie Cresner, Jessica Ng, Stephen Griffin, Sengamalai Manoharan, Ewan Brownlee
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引用次数: 0

摘要

目的:关于肾盂输尿管连接处的肾下极交叉血管是否排除了肢解肾盂成形术的必要性,一直存在着长期的争论。这些血管转位的后腹膜镜技术尚未在文献中描述。我们报告了我们的早期经验,后腹膜镜血管结手术转位的下极肾交叉血管,包括技术和结果。方法:对2022年3月至2024年4月接受后腹膜镜血管结扎手术治疗盆腔输尿管连接处梗阻的所有儿童进行单中心回顾性分析。收集症状缓解、超声前后径(APD)变化、MAG-3(巯基乙酰甘油三酯)肾图曲线、术后住院时间、并发症和进一步手术干预的数据。结果以中位数和四分位数范围报告。结果:10例患者(70%为男性,中位年龄11.7岁,范围8-13岁)术前APD为34 mm(23-40),随访2年。一名患者接受了桌上利尿剂应激试验。10名患者中有7名进行了日间手术,3名患者住院过夜。随访343天(122 ~ 456天)。术后APD为13 mm (6 ~ 23), APD变化为-18 mm(-25 ~ -10)。在MAG-3扫描中未观察到功能或摄取区域的丧失。2例患者术后因推测尿路感染接受抗生素治疗。90%的患者症状得到缓解,10个月后,1名患者接受了机器人辅助的肢解肾盂成形术。结论:在特定的儿童病例中,腹膜后镜下肾下极交叉血管的血管结是一种可接受的选择,而不是肢解肾盂成形术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retroperitoneoscopic Vascular Hitch Procedure for Pelvi-Ureteric Junction Obstruction in Children-The Southampton Experience.

Purpose: There has been a longstanding debate regarding whether lower pole renal crossing vessels on the pelvi-ureteric junction preclude the need for a dismembered pyeloplasty. A retroperitoneoscopic technique for a transposition of these vessels has not yet been described in the literature. We report our early experience of the retroperitoneoscopic vascular hitch procedure for transposition of lower pole renal crossing vessels, including technique and outcomes. Methods: Single-center retrospective review of all children who had a retroperitoneoscopic vascular hitch procedure for pelvi-ureteric junction obstruction from March 2022 to April 2024. Data on symptom resolution, change in sonographic anterior-posterior diameter (APD), MAG-3 (mercaptoacetyltriglycine) renogram curves, postoperative length of stay, complications, and further surgical interventions were collected. Results are reported as median and interquartile range. Results: Ten patients (70% male, median age 11.7 years, range 8-13 years) with preoperative APD of 34 mm (23-40) over the 2-year period were included. One patient received an on-table diuretic stress test. Seven out of 10 patients had day-case surgery, and 3 patients had an overnight stay. The follow-up period was 343 days (122-456). Postoperative APD was 13 mm (6-23), and the change in APD was -18 mm (-25 to -10). No loss of function or uptake areas on MAG-3 scans were observed. Two patients received antibiotics for a presumed urinary tract infection in the postoperative period. Symptom resolution was achieved in 90% of patients, and 1 patient underwent robotic-assisted dismembered pyeloplasty 10 months later. Conclusion: Retroperitoneoscopic vascular hitch for lower pole renal crossing vessels is an acceptable alternative to dismembered pyeloplasty in selected pediatric cases.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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