开放手术与后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床效果比较

【摘要】 目的对比腹膜后腹腔镜与传统开放性离断式肾盂成形术治疗输尿管连接部梗阻(UPJO)的效果,并总结后腹腔镜离断式肾盂成形术的适应证、手术技巧及临床应用价值。方法将2008年2月～2011年1月收治76例UPJO的患者作为腹膜后腹腔镜组。设同期行开放性离断式肾盂成形术的42例为开放性手术组。观察比较手术时间、术中出血量、术后肠道排气时间、住院时间、术后并发症和肾积水复发情况。结果两组均成功完成手术,后腹腔镜手术组术中无一例中转开放手术。后腹腔镜手术组在手术时间、术中出血量、术后肠道排气时间、术后住院天数和术后并发症发生率方面均优于开放手术组,差异具有显著性(P<0.05);而在术后肾积水复发率方面差异无统计学意义(P>0.05)。结论后腹腔镜离断式肾盂成形术是治疗UPJO梗阻有效、安全的术式,可代替开放手术,作为UPJO患者的首选术式。更多还原

【Abstract】 Objective To compare the retroperitoneal laparoscopic and traditional open pyeloplasty from off-type treatment of ureteropelvic junction obstruction(UPJO) results and summarizes the breaking of style after the laparoscopic pyeloplasty indications,surgical technique and clinical application value.Methods February 2008 to January 2011 patients treated 76 cases of UPJO as retroperitoneal laparoscopic group.Set off from the same line-style open pyeloplasty in 42 cases of open surgery group.Operative time blood loss postoperative intestinal exhaust time hospital stay,postoperative complications and recurrence of hydronephrosis were observed and compared.Results Both groups successfully completed surgery,laparoscopic surgery group no case of intraoperative conversion to open surgery.After the laparoscopic surgery group in the operation time,blood loss postoperative intestinal discharge time,postoperative hospital stay and postoperative complication rates were better than open surgery group the difference was significant(P>0.05);and hydronephrosis in the postoperative recurrence rate was no significant difference(P<0.05).Conclusion The disarticulation type retroperitoneal laparoscopic pyeloplasty is the treatment of UPJO obstruction effective and safe procedure and can replace open surgery as the preferred surgical patients UPJO.更多还原