经尿道输尿管镜下2μm激光汽化切除术治疗小儿后尿道瓣膜症

Transurethral 2μm laser vaporesection for treatment of posterior urethral valves by ureteroscopy in pediatrics

  • 摘要: 目的 探讨经尿道输尿管镜下2μm激光汽化切除术治疗小儿后尿道瓣膜症的临床效果。 方法 对2011年3月- 2014年12月在解放军第252医院接受经尿道输尿管镜下2μm激光汽化切除术治疗的27例小儿后尿道瓣膜症进行回顾性分析。本组病例均为男性,年龄(5.0±2.9)岁。采用F 8/9.8输尿管镜和2μm激光手术系统,在尿道的5点、7点处切开后尿道瓣膜,并将残余瓣膜汽化切除,术后1个月、3个月及6个月随访,观察其临床效果。 结果 全部病例顺利完成手术,随访治疗期间25例病情明显好转,单次手术成功率92.6%(25/27);1例瓣膜残余,经二次手术病情好转;1例失访。 结论 应用经尿道输尿管镜下2μm激光汽化切除术治疗小儿后尿道瓣膜症出血少、围术期安全性高、操作简便,是较为理想的微创手术方法。

     

    Abstract: Objective To explore the efficacy of 2μ m laser vaporesection in treating pediatric posterior urethral valves (PUVs) by ureterscopy. Methods A total of 27 cases with PUVs who received 2μ m laser vaporesections were reviewed. All patients were male with a mean age of (5.0±2.9) years. The clinical efficacy was reviewed. Under monitoring by F8/9.8 ureteroscopy, incisions were carried at 5 and 7 o’ clock positions of PUVs, and then remnant valves were evaporated by 2μ m laser. Routine follow-ups were conducted at the 1st, 3rd, and 6th months. Results All operations were successfully performed. Of the 27 cases, 25 cases got satisfied results during follow-up with successful operation rate of 92.6% (25/27). 1 case received re-operation, and 1 case lost follow-up. Conclusion Transurethral 2μ m laser vaporesection by ureteroscopy is a superior micro-invasive surgery method for pediatrics with posterior urethral valves, with little blood loss, high safety, convenient operation and infrequent complications.

     

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