小儿肾盂成形术后再梗阻因素研究进展
Research Progress on Factors Contributing to Recurrent Obstruction after Pyeloplasty in Children
DOI: 10.12677/acm.2025.1551416, PDF,   
作者: 余晨惠, 李志鹏*：昆明医科大学第二附属医院泌尿外科，云南 昆明
关键词: 小儿；肾盂成形术；再梗阻因素；机器人辅助；研究进展；Pediatric； Pyeloplasty； Re-Obstruction Factors； Robot-Assisted； Research Progress
摘要: 小儿先天性肾盂输尿管连接部梗阻(ureteropelvic junction obstruction, UPJO)是儿童最常见的先天性畸形之一，以先天性肾积水(congenital hydronephrosis, CHn)为显著表现。离断式肾盂成形术(Anderson-Hynes)是当下UPJO患儿的最优治疗术式。部分患儿术后再次出现梗阻及肾积水。本文对小儿肾盂成形术后再梗阻相关因素的研究现状进行综述，涵盖手术技术、患儿个体特质、围手术期操作等多方面因素，旨在为减少UPJO患儿术后再次梗阻的发生率以及提高手术治疗效果提供理论依据和实践指导。
Abstract: Congenital ureteropelvic junction obstruction (UPJO) is among the most prevalent congenital deformities in children, with congenital hydronephrosis (CHN) being its prominent manifestation. Currently, the top-notch treatment option for children suffering from UPJO is dismembered pyeloplasty, also known as the Anderson-Hynes procedure. Nevertheless, a certain number of children encounter recurring obstruction and hydronephrosis after the operation. This article offers a comprehensive overview of the current research on the factors related to recurrent obstruction following pyeloplasty in children. It takes into account various aspects such as surgical techniques, the unique characteristics of individual children, and perioperative procedures. The intention is to offer both theoretical and practical advice for lowering the occurrence of postoperative recurrent obstruction and enhancing the surgical results for children with UPJO.
文章引用：余晨惠, 李志鹏. 小儿肾盂成形术后再梗阻因素研究进展[J]. 临床医学进展, 2025, 15(5): 634-640. https://doi.org/10.12677/acm.2025.1551416

参考文献

[1] 杜天赐. 腹腔镜肾盂成形术入路选择和再梗阻危险因素分析[D]: [硕士学位论文]. 兰州: 兰州大学, 2022.
[2] 刘德鸿, 李品, 路腾飞, 等. 机器人辅助腹腔镜肾盂成形术治疗儿童肾盂成形术后肾梗阻的初经验[J]. 微创泌尿外科杂志, 2024, 13(4): 248-251.
[3] Lim, D.J. and Walker, R.D.I. (1996) Management of the Failed Pyeloplasty. Journal of Urology, 156, 738-740. [Google Scholar] [CrossRef] 
[4] Gao, W., Zhang, L., He, Y., et al. (2023) Analysis of the Efficacy and Risk Factors of Surgical Treatment of Recurrent UPJO in Adults. International Urology and Nephrology, 55, 1493-1499.
[5] Tan, H., Ye, Z., Roberts, W.W. and Wolf, J.S. (2011) Failure after Laparoscopic Pyeloplasty: Prevention and Management. Journal of Endourology, 25, 1457-1462. [Google Scholar] [CrossRef] [PubMed]
[6] Mucksavage, P. (2020) Editorial Comment On: “Risk Factors and Management Options for the Adult Failed Ureteropelvic Junction Obstruction Repair in the Era of Minimally Invasive and Robotic Approaches: A Comprehensive Literature Review” by Chow et al. Journal of Endourology, 34, 1119-1120. [Google Scholar] [CrossRef] [PubMed]
[7] Song, S.H., Lee, C., Jung, J., Kim, S.J., Park, S., Park, H., et al. (2017) A Comparative Study of Pediatric Open Pyeloplasty, Laparoscopy-Assisted Extracorporeal Pyeloplasty, and Robot-Assisted Laparoscopic Pyeloplasty. PLOS ONE, 12, e0175026. [Google Scholar] [CrossRef] [PubMed]
[8] Lucas, S.M., Sundaram, C.P., Wolf, J.S., Leveillee, R.J., Bird, V.G., Aziz, M., et al. (2012) Factors That Impact the Outcome of Minimally Invasive Pyeloplasty: Results of the Multi-Institutional Laparoscopic and Robotic Pyeloplasty Collaborative Group. Journal of Urology, 187, 522-527. [Google Scholar] [CrossRef] [PubMed]
[9] Weiss, D.A., Kadakia, S., Kurzweil, R., Srinivasan, A.K., Darge, K. and Shukla, A.R. (2015) Detection of Crossing Vessels in Pediatric Ureteropelvic Junction Obstruction: Clinical Patterns and Imaging Findings. Journal of Pediatric Urology, 11, 173.e1-173.e5. [Google Scholar] [CrossRef] [PubMed]
[10] 曾宸, 吴素青, 陈艳红, 等. 双肾体积比值在小儿先天性肾积水术后评价的意义[J]. 当代医学, 2022, 28(15): 16-21.
[11] Madi, R., Roberts, W.W. and Wolf, J.S. (2008) Late Failures after Laparoscopic Pyeloplasty. Urology, 71, 677-680. [Google Scholar] [CrossRef] [PubMed]
[12] Stein, R.J., Turna, B., Patel, N.S., et al. (2009) Laparoscopic Assisted Ileal Ureter: Technique, Outcomes and Comparison to the Open Procedure. Journal of Urology, 182, 1032-1039.
[13] Kim, E.J., Song, S.H., Sheth, K., Baccam, T., Elizondo, R., Baek, M., et al. (2019) Does De Novo Hydronephrosis after Pediatric Robot-Assisted Laparoscopic Ureteral Re-Implantation Behave Similarly to Open Re-Implantation? Journal of Pediatric Urology, 15, 604.e1-604.e6. [Google Scholar] [CrossRef] [PubMed]
[14] 张一帆, 郝春生, 任玉乾. 腹腔镜下Anderson-Hynes肾盂输尿管成形术治疗6个月以下婴儿肾盂输尿管连接部梗阻[J]. 中国微创外科杂志, 2019, 19(7): 587-591.
[15] 任伟刚, 段燚星. 后腹腔镜精准辅助小切口离断肾盂成形术治疗小儿肾盂输尿管连接部梗阻(附22例报告) [J]. 中国内镜杂志, 2019, 25(1): 89-93.
[16] 黄光彬, 李庚, 高贺云, 等. 单孔机器人技术在婴幼儿泌尿系手术中的应用[J]. 临床外科杂志, 2023, 31(5): 419-422.
[17] Esposito, C., Autorino, G., Castagnetti, M., Cerulo, M., Coppola, V., Cardone, R., et al. (2021) Robotics and Future Technical Developments in Pediatric Urology. Seminars in Pediatric Surgery, 30, Article ID: 151082. [Google Scholar] [CrossRef] [PubMed]
[18] Faria, E.F. (2020) Editorial Comment: Laparoscopy versus Robotic-Assisted Pyeloplasty in Children: Preliminary Results of a Pilot Prospective Randomized Controlled Trial. International braz j urol, 46, 655-656. [Google Scholar] [CrossRef] [PubMed]
[19] Blanc, T., Abbo, O., Vatta, F., Grosman, J., Marquant, F., Elie, C., et al. (2022) Transperitoneal versus Retroperitoneal Robotic-Assisted Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in Children. a Multicentre, Prospective Study. European Urology Open Science, 41, 134-140. [Google Scholar] [CrossRef] [PubMed]
[20] Song, P., Shu, M., Peng, Z., Yang, L., Zhou, M., Wang, Z., et al. (2022) Transperitoneal versus Retroperitoneal Approaches of Pyeloplasty in Management of Ureteropelvic Junction Obstruction: A Meta-Analysis. Asian Journal of Surgery, 45, 1-7. [Google Scholar] [CrossRef] [PubMed]
[21] Wu, G., Li, H., Zhong, P., Chen, D., Zhang, Z., Guo, Z., et al. (2021) Initial Experience with the Comprehensive Modified Laparoscopic Pyeloplasty Technique Based on Membrane Anatomy for Treating Ureteropelvic Junction Obstruction. Urologia Internationalis, 106, 487-494. [Google Scholar] [CrossRef] [PubMed]
[22] Zhao, P., Wang, C., Mao, K., Luo, Z., Li, Y., Zhou, G., et al. (2022) Comparative Study of Different Surgical Approaches for Treatment of UPJ Obstruction According to the Degree/severity of Hydronephrosis Factor. Frontiers in Pediatrics, 10, Article 966292. [Google Scholar] [CrossRef] [PubMed]
[23] 娄安锋, 王焱, 张国贤, 等. 离断式肾盂成形术对小儿肾积水的疗效及相关影响因素探究[J]. 航空航天医学杂志, 2021, 32(8): 928-930.
[24] Shahnawaz, Shahzad, A., Shahzad, I., et al. (2014) Our Experience with Open Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction. Pakistan Journal of Medical Sciences, 30, 153-156.
[25] Wahyudi, I., Tendi, W., Rahman, F., Situmorang, G.R. and Rodjani, A. (2021) Minimal Invasive Treatment in Pelvic-Ureteric Junction Obstruction: A Comprehensive Review. Research and Reports in Urology, 13, 573-580. [Google Scholar] [CrossRef] [PubMed]
[26] 张云龙, 余伟民, 程帆, 等. 腹腔镜肾部分切除术治疗肾脏上组肾盏颈闭锁的疗效分析[J]. 临床外科杂志, 2020, 28(8): 781-783.
[27] 陈周彤, 林厚维, 徐卯升, 等. 儿童肾盂输尿管连接部梗阻术后再手术病因分析[J]. 第二军医大学学报, 2020, 41(2): 216-220.
[28] Seo, I.Y., Oh, T.H. and Lee, J.W. (2014) Long-term Follow-Up Results of Laparoscopic Pyeloplasty. Korean Journal of Urology, 55, 656-659. [Google Scholar] [CrossRef] [PubMed]

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