探讨机器人辅助治疗肾盂输尿管连接处狭窄（Ureteropelvic junction obstruction，UPJO）和同期治疗继发性与多发性肾结石的临床安全性。方法：回顾性分析1例机器人辅助治疗UPJO合并继发性和多发性肾结石患者的临床资料，包括术前一般检查、围手术期和术后复查资料。结果：患者顺利完成机器人辅助腹腔镜下左侧肾盂输尿管成形术+左侧肾盂切开取石术，术后复查结果提示所有继发性肾结石完全取净。结论：机器人辅助治疗UPJO合并继发性和多发性肾结石的手术是安全、可行的，且手术创伤小，无需二期处理继发性肾结石。

To investigate the efficacy and feasibility of robot-assisted laparoscopic pyeloureterostomy in the treatment of ureteropelvic junction obstruction (UPJO) complicated with multiple and secondary renal calculi. Methods: A patient with UPJO complicated with multiple and secondary renal calculi underwent robot-assisted laparoscopic pyeloureterostomy was retrospectively analyzed. Perioperative and postoperative data were also collected and analyzed. Results: The robot-assisted laparoscopic pyeloureteroplasty and pyelolithotomy were successfully completed. The stones in the pelvis and calyx were fully removed. Conclusion: Robot-assisted laparoscopy is feasible and safe in the treatment of UPJO complicated with multiple and secondary renal calculi.

收稿日期：2021-03-18 录用日期：2021-09-31

Received Date: 2021-03-18 Accepted Date: 2021-09-31

基金项目：甘肃省自然科学基金（17JR5RA333）

Foundation Item: Natural Science Foundation of Gansu Province (17JR5RA333)

通讯作者：周逢海，Email：zhoufengh163.com

Corresponding Author: ZHOU Fenghai, Email: zhoufengh@163.com

引用格式：刘强照，张晓峰，马得茸，等. 机器人辅助下同期治疗肾盂输尿管连接处狭窄合并继发性肾结石一例报道[J]. 机器人外科学杂志（中英文），2022，3（3）：207-211.

Citation: LIU Q Z, ZHANG X F, MA D R, et al. Robot-assisted laparoscopic pyeloureterostomy for urethral pelvic junction obstruction combined with secondary renal calculi: a case report[J]. Chinese Journal of Robotic Surgery, 2022, 3(3): 207-211.

[1] Paraboschi I, Mantica G, Dalton N R, et al. Urinary biomarkers in pelvic-ureteric junction obstruction: a systematic review[J]. Translational Andrology Urology,2020, 9(2): 722-742.

[2] Kausik S, Segura J W. Surgical management of ureteropelvic junction obstruction in adults[J]. Int Braz J Uro, 2003, 29(1): 3-10.

[3] 那彦群, 叶章群, 孙颖浩, 等. 中国泌尿外科疾病诊疗指南[M]. 北京: 人民卫生出版社, 2013:374-378.

[4] 向鹏, 武进峰, 李静. 先天性肾盂输尿管连接部梗阻外科治疗进展[J]. 临床泌尿外科杂志, 2015,20 (10): 755-758.

[5] 李哲学. 肾盂输尿管连接部梗阻伴肾功能损害的治疗进展[J]. 现代医药卫生, 2016, 32 (8): 1200-1203.

[6] Wein A J, Kavoussi L R, Novick A C, et al. Campbeel-Walsh Urology[M]. Tenthed. Philadelphia: Saunders,2011: 1125-1171.

[7] 张诚, 张克, 任瑞民. 等. 肾盂输尿管连接部梗阻的外科治疗进展[J]. 临床泌尿外科杂志, 2016,31 (2): 185-188.

[8] Eden C G. Minimally invasive treatment of ureteropelvic junction obstruction: a critical analysis of results[J]. Eur Urol, 2007, 52(4): 983-989.

[9] Schuessler W W, Grune M T, Tecuanhuey L V, et al.Laparoscopic dismembered pyeloplasty[J]. J Urol, 1993,150(6): 1795-1799.

[10] Autorino R, Eden C, El-Ghoneimi A, et al. Robotassisted and laparoscopic repair of ureteropelvic junction obstruction: a systematic review and metaanalysis[J]. Eur Urol, 2014, 65(2): 430-452.

[11] Gettman M T, Neururer R, Bartsch G, et al. Anderson-Hynes dismembered pyeloplasty performed using the da Vinci robotic system[J]. Urology, 2002, 60(3): 509-513.

[12] Atug F, Castle E P, Burgess S V, et al. Concomitant management of renal calculi and pelvi-ureteric junction obstruction with robotic laparoscopic surgery[J]. BJU Int, 2005, 96(9): 1365-1368.

[13] Swearingen R, Sood A, Madi R, et al. Zero-fragment Nephrolithotomy: a multi-center evaluation of robotic pyelolithotomy and nephrolithotomy for treating renal stones[J] Eur Urol, 2017, 72(6): 1014-1021.

[14] 简钟宇, 陈吉祥, 李虹, 等. 离断性机器人辅助、腹腔镜和开放肾盂成形术治疗成人肾盂输尿管连接处梗阻疗效的Meta 分析[J]. 中华泌尿外科杂志,

2019, 40(6): 456-461.

[15] Silay M S, Danacioglu O, Ozel K, et al. Laparoscopy versus robotic-assisted pyeloplasty in children: preliminary results of a pilot prospective randomized controlled trial[J]. World J Urol, 2020, 38(8): 1841-1848.

[16] Andolfi C, Adamic B, Oommen J, et al. Robot-assisted laparoscopic pyeloplasty in infants and children: is it superior to conventional laparoscopy?[J]. World J Urol,2020, 38(8): 1827-1833.