Qingjun Meng, Chuanliang Wang, Zhan Gao, Chaopeng Xu, Zehua Wang, Jinglin Fang, Lingang Cui, Pengchao Lian, Kang Gao, Yukui Gao
Background: To investigate the indications, operation techniques in the treatment of giant hydronephrosis by transabdominal laparoscopic resection of giant hydronephrosis.
Methods: A total of 26 patients with giant hydronephrosis from our urological department in two years were retrospectively analyzed, including 18 cases of stricture of pyeloureteric junction, 1 case of hydronephrosis caused by gynecology, renal tuberculosis complicated with hydronephrosis in 1 case. All 26 cases underwent transperitoneal nephrectomy. Using ultrasound knife and electrical hook instrument separate kidney and Hem-O-lock clip the renal vessels.
Results: In the total number of the 26 cases, 23 patients were successfully completed by laparoscopic nephrectomy. One patient by hand holds of laparoscopic nephrectomy because of the severe adhesion between kidney and its surrounding tissue. Another case, through the giant hydronephrosis was punctured when the safety Trocar punch into the abdominal cavity, but still completed by laparoscopic nephrectomy. The average operation time was 100 (range, 100–140) min. The average blood loss was 50 (range, 30–80) mL, 1–3 days after discharge, drainage tube was removed after 2–4 days, no surgical complications. The average hospitalization was 6 days. Postoperative pathology showed renal parenchymal atrophy, glomerular number decreased with fibrosis. Twenty-three cases were postoperative followed-up (range, 3–18 months), all patients had normal renal function.
Conclusions: Transperitoneal laparoscopic nephrectomy has a large operation space, small trauma and other advantages, the exact effect, is an ideal operation in the treatment of giant hydronephrosis.
