以腹腔鏡輸尿管剝離術治療後腹腔纖維化併尿路阻塞病變
台北市立聯合醫院醫院經驗報告
賴昱維1,2 、薛又仁1,2、 黃建榮1, 2 、邱逸淳1,2 、陳修聖1,2、 邱文祥1,2
台北市立聯合醫院外科部泌尿外科1
國立陽明大學醫學院泌尿學科2
Laparoscopic ureterolysis in patients with retroperitoneal fibrosis and obstructive uropathy: taipei city hospital experience.
Yu-Wei Lai、Thomas Y. Hsueh、Andy C. Huang、Yi-Chun Chiu、Shiou-Sheng Chen、Allen W. Chiu
Divisions of Urology, Department of Surgery, Taipei City Hospital, Taiwan1
National Yang-Ming University, School of Medicine, Taiwan2
Purpose: To analyze the outcomes of laparoscopic ureterolysis (LU) in retroperitoneal fibrosis (RPF) with obstructive uropathy.
PATIENTS AND METHODS:
Records of 5 patients with RPF who had obstructive uropathy at presentation and had undergone LU at our hospital during January 2010 to Decemberb 2014 were collected and analyzed.
RESULTS:
Two females and three males underwent LU for RPF. Underlying causes of RPF could not be found in 1 (20%) cases. All patients underwent sigle side LU. Mean operative time and estimated blood loss were 78 minutes (range, 45-125 minutes) and 180 mL (range, 60-400 mL), respectively. No case required conversion to open surgery. No significant intraoperative complication (0/5 [0%]) was noted. Only one patient (1/5 [20%]) need blood transfusion because intraoperative bleeding . The postoperative complication rate was 0% (0/5). Most complications were minor and did not need specific treatment. The mean follow-up period was 20 months (range, 6-45 months). The success rate at last follow-up was 100%. After operation, no patient had obstructive uropathy and symptomatic flank pain.
CONCLUSIONS:
Treatment of RPF is still controversial. Laparoscopic ureterollysis to treat obstructive uropathy because of retroperitonal fibrosis is safe, feasible and effective