在机器人辅助下重新定位一名14岁血管肾积水患儿的异常下肾血管

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在本研究中，我们使用 Hellström - Chapman 机器人手术治疗了一名因下极血管异常引起的肾盂尿道段阻塞患者，并报告了短期疗效。伊尔库茨克州儿童临床医院收治了一名14岁女孩，她的肾盂输尿管交界处因受到异常下极血管的外部压迫而阻塞。诊断是根据超声波和多普勒超声波检查确定的，并经对比增强计算机断层扫描确认。手术使用英国CMR公司生产的Versius手术机器人进行。通过精细的操作将异常血管移动到骨盆前壁。然后用骨盆前壁将其"包裹"起来。术后随访包括术后 1、3 和 6 个月的临床评估和肾脏超声波检查。手术时间为65分钟。在机器人辅助 Hellström-Chapman 手术中，没有观察到对肾脏和邻近器官供血血管造成损伤的术中并发症。患者无需进行上尿路内外引流或肾盂旁引流。肾盂的前胸直径从30毫米降至8毫米。肾血管血流阻力指数从0.74降至 0.58。Hellström-Chapman机器人手术可以说是矫正血管性肾积水的一种安全有效的手术。这种相对简单的操作需要对患者进行筛选，才能保证治疗的进一步成功。

作者简介

Yury A. Kozlov

Children’s Regional Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education; Irkutsk State Medical University

Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
SPIN 代码: 3682-0832

MD, Dr. Sci. (Med.), Corresponding Member of Russian Academy of Sciences

俄罗斯联邦, Irkutsk; Irkutsk; Irkutsk

Simon S. Poloyan

Children’s Regional Clinical Hospital; Irkutsk State Medical University

Email: simonpoloyan@ya.ru
ORCID iD: 0000-0001-7042-6646
俄罗斯联邦, Irkutsk; Irkutsk

Eduard V. Sapukhin

Children’s Regional Clinical Hospital

Email: sapukhin@yandex.ru
ORCID iD: 0000-0001-5470-7384

MD, Cand. Sci. (Med.)

俄罗斯联邦, Irkutsk

Aleksei S. Strashinsky

Children’s Regional Clinical Hospital

Email: Leksus-642@yandex.ru
ORCID iD: 0000-0002-1911-4468
俄罗斯联邦, Irkutsk

Marina V. Makarochkina

Children’s Regional Clinical Hospital

Email: m.makarochkina@gmail.com
ORCID iD: 0000-0001-8295-6687
SPIN 代码: 4600-4071
俄罗斯联邦, Irkutsk

Andrey A. Marchuk

Children’s Regional Clinical Hospital

Email: simonpoloyan@ya.ru
ORCID iD: 0000-0001-9767-0454
俄罗斯联邦, Irkutsk

Alexander P. Rozhanskii

Irkutsk State Medical University

编辑信件的主要联系方式.
Email: alexanderozhanski@mail.ru
ORCID iD: 0000-0001-7922-7600
俄罗斯联邦, Irkutsk

Anton A. Byrgazov

Children’s Regional Clinical Hospital

Email: byrgazov.ant-doc38@yandex.ru
ORCID iD: 0000-0002-9195-5480
俄罗斯联邦, Irkutsk

Elizaveta S. Romanovich

Irkutsk State Medical University

Email: rom_94_00@mail.ru
ORCID iD: 0009-0005-1795-9386
俄罗斯联邦, Irkutsk

Artem N. Narkevich

South Ural State Medical University; V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University

Email: narkevichart@gmail.com
ORCID iD: 0000-0002-1489-5058
SPIN 代码: 9030-1493

MD, Dr. Sci. (Med.)

俄罗斯联邦, Chelyabinsk; Krasnoyarsk

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补充文件

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1. JATS XML
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2. Fig. 1. Contrast computed tomography of the kidney: the arrow illustrates the aberrant lower polar vessel, which is the reason for the obstruction of the pyeloureteral junction

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3. Fig. 2. Hellström – Chapman robot-assisted surgery. Stage of the mobilization of aberrant lower polar renal vessels. 1 — ureter; 2 — aberrant renal vessels; 3, kidney pelvis

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4. Fig. 3. Hellström – Chapman robot-assisted surgery. Stage of the transposition of aberrant lower polar renal vessels. 1 — kidney pelvis; 2 — aberrant renal vessels

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5. Fig. 4. Hellström – Chapman robot-assisted surgery. Stage of “wrapping” the aberrant lower polar renal vessels with the fabric of the pelvis

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