Objective:To analyze and summarize the clinical experience and therapeutic effects of renal pelvis flap ureteral reconstruction surgery in long-segment upper ureteral stricture.Methods:Clinical data of 26 patients undergoing renal pelvis flap ureteroplasty in the Department of Urology of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2022 to December 2023 were an-alysed retrospectively,including 16 cases of congenital ureteropelvic junction obstruction(5 cases of re-stricture after ureteroplasty),and 10 cases of upper ureteral stricture after ureteroscopic holmium lithotripsy.Urinary ima-ging examinations were performed in all patients,and the results showed that the stricture length of the upper ure-ter was between 3-7 cm.Among all 26 patients,renal pelvis flaps were used for reconstructions of the uretero-pelvic junction during surgery,which includes 6 cases of laparoscopic surgery,and 20 cases of da Vinci robot-as-sisted laparoscopic surgery.Then the operation time,average bleeding volume,average postoperative hospitaliza-tion time,postoperative anteroposterior diameter alterations of renal pelvis,and clinical symptom improvement of patients were analyzed.Results:All cases were completed by laparoscopy or robot-assisted laparoscopy,and there was no conversion to open surgery.Among 6 cases of laparoscopic pelvic flap ureteroplasty,the average operation time was(131±46)minutes,the average intraoperative blood loss was(103±66)mL,the average postoperative hospitalization time was(7±5)days,postoperative anteroposterior diameter reduction rate of renal pelvis was 95.33％,and abdominal pain or lower back pain were all relieved after surgeries.While among 20 cases of robot-assisted laparoscopic pelvic flap ureteroplasty,the average operation time was(127±24)minutes,the average in-traoperative blood loss was(48±24)mL,the average postoperative hospitalization time was(5.7±1.2)days,postoperative anteroposterior diameter reduction rate of renal pelvis was 97.00％.Symptoms such as abdominal pain or lower back pain were all relieved after surgeries.Conclusion:Renal pelvic flap ureteroplasty has achieved good therapeutic effects in the treatment of long-segment upper ureteral stricture,and the operation is well con-trolled and conducted.Moreover,robot-assisted laparoscopic surgery has clinical significance and promising pros-pects compared to laparoscopic surgery.However,currently most reported studies were conducted in single center with small sample size,therefore,prospective studies with larger sample size and long-term follow-up data are still needed to further evaluate its clinical efficacy.
NETL
NSTL
万方数据
