输尿管肾切除术

From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术，其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症，将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较，对数据进行统计分析。

The positive rates of retrograde ureteropyelography,CT scanning,IVP,ultrasonography were86.7%、50%、12.5%、12.5%respectively.31of40cases were treated by total nephroureterectomy with segmental cystectomy,3cases by segˉmental ureterocystectomy with ureteroneocystostomy,2cases by segmental ureterectomy with end-to-end anastomoˉsis,2cases by single resection of tumor,2cases by resection of residual ureter with segmental cystectomy.

逆行输尿管插管造影、CT、IVP、B超检查的阳性率分别是86.7%、50%、12.5%、12.5%。40例患者中行患肾+全段输尿管+膀胱部分切除术31例，输尿管下段切除术+膀胱吻合术3例，输尿管肿瘤切除+输尿管端端吻合术2例，单纯输尿管肿瘤切除术2例。

Results Conservative treatment was carried out for 4 patients, ureteroureterostomy for 7 patients, ureteroneocystostomy for 22 patients, bladder valve-ureter anastomosis for 2 patients, vermiform appendix-ureter replacement for 2 patients, and nephrectomy for 1 patients.

结果 4例行双J管保守治疗，7例(9侧)行输尿管端端吻合术，2 2例行输尿管膀胱再植术，2例行膀胱壁瓣输尿管吻合术，2例行阑尾代右侧部分输尿管术，1例行肾切除术。

Since Clayman successfully performed laparoscopic nephrectomy for an oncocytoma patient in June 1990, the laparoscopic technique in urology has been developed dramatically.

自从Clayman于1990年6月成功地为一位肾脏嗜酸细胞瘤患者施行腹腔镜肾切除术以来，腹腔镜技术在泌尿外科领域得到了较快的发展，尤其是随后5年，在肾、肾上腺、前列腺癌及输尿管结石的外科治疗方面，越来越多的泌尿外科医生开始采用这一技术，并且泌尿外科腹腔镜水平的高低成为衡量医院综合竞争力的重要标准之一。

Three Cases with hydronephrosis were located in left kindey, and 3 cases in bilateral kidneys. Of 5 kidneys in 4 cases of ureteropelvic junction obstruction, Anderson-Heny's procedure was performed in 4 kidneys, and nephrectomy was performed in 1 hydronephrotic kidney because the renal function had lost. Cohen's procedure was performed in all 3 individual hydronephrotic kidneys in 2 cases.

病因及治疗：肾盂输尿管连接部梗阻4例5只肾，4只肾做了Anderson-Heny's手术，1只肾无功能行肾切除术；2例3只肾为巨输尿管症，均行Cohen's法输尿管膀胱移植术，其中1例合并膀胱重复畸形，手术中同时行共同壁切除；l例出生后肾积水渐减轻，未特殊处理，正在随访中。

The conalescence results and oncologic outcomes were analyzed and compared with the corresponding data from 41 contemporary conentional open nephroureterectomy procedures.

分析患者恢复情况以及肿瘤细胞学结果并与41例同时行传统开放性输尿管肾切除术者的相应资料进行比较。

Objective To study the treatment and diagnosis of postcaval ureter.Methods Among8cases with postcaval ureter,6cases underwent ureteroureterostomy before vena cava,1case ureteroureterostomy after cutting inferior vena cava,1case right nephrectomy.

目的 探讨腔静脉后输尿管的临床诊断与治疗方法对8例腔静脉后输尿管中6例行腔静脉端端吻合，1例切断下腔静脉再吻合，1例行右肾切除术。

Methods Among8cases with postcaval ureter,6cases underwent ureteroureterostomy before vena cava,1case ureteroureterostomy after cutting inferior vena cava,1case right nephrectomy.

对8例腔静脉后输尿管中6例行腔静脉前端端吻合，1例切断下腔静脉再吻合，1例行右肾切除术。

Renal function of recipient was normal after 3 days. Conclusion: Transperitoneal laparoscopic nephrectomy in live-donor is a safe and effective procedure, which provides kidney with satisfactory blood vessels and ureter for graft.

经腹腔路径腹腔镜活体供肾切除术可以满意解剖肾血管和保留足够长的输尿管，而且安全、有效，创伤小、恢复快、痛苦少，供者易于接受。

Methods: From January 2004 to September 2006, 56 laparoscopic nephrectomies were performed. Hem-o-lok clips were used to control renal artery and vein in 38 cases, including 9 simple nephrectomies, 18 radical nephrectomies and 11 nephroureterectomies.

2004年1月至2006年9月我科行腹腔镜肾切除术56例，其中38例术中应用Hem-o-lok夹处理肾蒂血管，包括腹腔镜单纯肾切除9例，腹腔镜肾癌根治术18例，腹腔镜肾输尿管全长切除术11例。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。