儿童马蹄肾的机器人辅助腹腔镜肾盂成形术： 临床病例

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由于马蹄肾具有特殊的解剖学特点，包括肾脏尾侧位置、旋转异常、存在变异血管以及输尿管高位起始等，腹腔镜手术在此类患者中可能非常复杂。机器人技术的应用简化了该类手术操作。作者对一 例1岁马蹄肾合并肾盂输尿管连接部梗阻患儿的病史进行了回顾性分析。增强计算机断层扫描 是诊断肾积水病因的主要方法，并明确显示梗阻的真实原因为 输尿管自肾盂高位起始。患儿接受了 Anderson–Hynes术式的机器人辅助腹腔镜肾盂成形术。与解剖结构正常肾脏的手术相比，其主要区别在于 机器人端口的尾侧放置 以及对 肾脏血管解剖结构的高度关注。手术在完全机器人辅助下顺利完成，未需中转腹腔镜或开放手术。术中未发生与出血或邻近器官损伤相关的并发症。手术总时间，包括机器人对接，为165分钟，其中机器人对接时间15分钟，控制台操作时间150分钟。患儿住院时间为5天。肾盂造口管于术后第7天在门诊条件下拔除。分别于术前及术后6个月测定肾盂前后径。肾盂前后径由37 mm减少至8 mm。肾脏放射性核素检查的利尿性肾图显示无残余梗阻。研究结果证实，机器人辅助腹腔镜肾盂成形术用于马蹄肾患儿的治疗是安全、可行的，在专业医师操作下可取得良好手术效果。

作者简介

Yury A. Kozlov

Irkutsk State Regional Children’s 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. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

俄罗斯联邦, Irkutsk; Irkutsk; Irkutsk

Alexander P. Rozhanski

Irkutsk State Regional Children’s Clinical Hospital; 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
SPIN 代码: 4012-7120
俄罗斯联邦, Irkutsk; Irkutsk

Simon S. Poloyan

Irkutsk State Regional Children’s Clinical Hospital; Irkutsk State Medical University

Email: spolo@gmail.com
ORCID iD: 0000-0001-7042-6646
俄罗斯联邦, Irkutsk; Irkutsk

Eduard V. Sapukhin

Irkutsk State Regional Children’s Clinical Hospital

Email: sapukhin@yandex.ru
ORCID iD: 0000-0001-5470-7384
俄罗斯联邦, Irkutsk

Alexey S. Strashinsky

Irkutsk State Regional Children’s Clinical Hospital

Email: leksus-642@yandex.ru
ORCID iD: 0000-0002-1911-4468
SPIN 代码: 9210-5286
俄罗斯联邦, Irkutsk

Marina V. Makarochkina

Irkutsk State Regional Children’s Clinical Hospital

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

Andrey A. Marchuk

Irkutsk State Regional Children’s Clinical Hospital

Email: maa-ped20@yandex.ru
ORCID iD: 0000-0001-9767-0454
SPIN 代码: 5668-4896
俄罗斯联邦, Irkutsk

Sergey A. Muravev

Irkutsk State Medical University

Email: murv11@yandex.ru
ORCID iD: 0000-0003-4731-7526
SPIN 代码: 3965-6284
俄罗斯联邦, Irkutsk

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