小儿腹腔镜与开放离断式肾盂成形术的对比研究

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摘要目的:对比研究小儿腹腔镜离断式肾盂成形术(LP)与开放离断式肾盂成形术(OP)的临床疗效及安全性。方法:2006年1月~2012年12月对78例小儿肾盂输尿管连接部梗阻(UPJO) 的病例行腹腔镜或开放离断式肾盂成形术治疗,其中LP组40例,OP组38例。比较两组术前一般情况、手术时间、术中出血情况、术后恢复情况及术后并发症发生率等。结果:两组患儿术前一般情况均差异无统计学意义(P＞0. 05),并均顺利完成手术,LP组和OP组术后漏尿发生率及术后24个月患儿肾积水减轻情况均差异无统计学意义 (P＞0.05),LP组术中出血量、术后引流管放置时间、术后下床活动时间、切口疼痛时间、术后切口感染发生率、术后腹膜后血肿发生率及术后住院天数均低于OP组,而手术时间长于OP组,差异有统计学意义(P＜0.05)。结论:LP与OP相比,成功率相当,疗效肯定,但创伤和痛苦更小,术中出血和术后并发症更少,恢复更快,切口相对美观,是治疗小儿UPJO理想的手术方式。

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关键词 ：肾盂输尿管连接处梗阻, 离断式肾盂成形术, 腹腔镜

Abstract：Objective: To compare the clinical efficacy and security of laparoscopic dismembered pyeloplasty (LP) vs. open dismembered pyeloplasty (OP) surgery in children. Methods: The clinical data of 78 children with simple ureteropelvic junction obstruction (UPJO) from Jan. 2006 to Dec. 2012 were retrospectively analyzed, and the patients were divided into two groups: the LP group (n=40) given LP, and the OP group (n=38) subject to OP. The operative time, intraoperative blood loss, postoperative recovery, and postoperative complications were analyzed in the two groups. Results: Both LP and OP operations were completed successfully in two groups. There was no statistically significance difference (P＞0.05) in age, gender, affected side and lesion pain severity between the two groups. The incidence of postoperative urinary leakage and postoperative decrease of hydronephrosis between two groups showed no significant difference (P>0.05). Blood loss, storage of drainage tube, off-bed ambulation time, incision pain time, the incidence of postoperative incision infection, the incidence of retroperitoneal hematoma and postoperative hospital stay in LP group were reduced as compared with OP group, and the operative time in LP group was slightly longer (P＜0.05 for all). Conclusions: LP surgery in children has higher successful rate, less complications, less blood loss, quicker recovery, less pain and better wound healing than OP, and LP may be the standard method for the treatment of UPJO in children.

Key words： ureteropelvic junction obstruction dismembered Anderson-Hynes pyeloplasty laparoscopy

收稿日期: 2015-10-16

ZTFLH:

R692

通讯作者: 周林玉,zhoulinyu6@126.com

引用本文:

刘树瀚,谈宜傲,乔龙标,周林玉,孙友文. 小儿腹腔镜与开放离断式肾盂成形术的对比研究[J]. 微创泌尿外科杂志, 2016, 5(1): 1-4.
Liu Shuhan, Tan Yi'ao, Qiao Longbiao, Zhou Linyu, Sun Youwen,. Comparative study on dismembered pyeloplasty by laparoscopy vs. open surgery in children. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(1): 1-4.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1115.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2016/V5/I1/1

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