摘要
目的比较两种不同手术入路腹腔镜肾盂成形术治疗儿童肾盂输尿管连接部梗阻性肾积水的手术效果。方法收集本院2012年3月至2014年12月收治的60例肾积水患儿资料,其中后腹腔镜手术30例(A组),经脐单部位腹腔镜手术30例(B组),比较两组在手术时间、术中估计出血量、术中并发症、留置引流管时间、术后恢复饮食时间、术后住院时间、手术成功率等方面的差别。结果60例手术均获得成功,无中转开放手术,两组在术中估计出血量、术后恢复饮食时间、术后住院时间等方面差异均无明显统计学意义,而A组的手术时间(138.1±15.1)分钟略长于B组的(96.7±10.2)分钟,A组的留置引流管时间(1.3±0.4)天略短于B组的(1.8±1.0)天。B组术中出现1例十二指肠浆膜损伤,术中及时修补。A组术中未出现并发症。结论后腹腔及经脐单部位腹腔镜肾盂成形术治疗小儿肾积水安全可行,但经脐单部位腹腔镜具有操作空间大、美容效果更好的优势,值得临床推广。
Objective To compare the clinical effectiveness and safety of retroperitoneal and transumbilical single-site laparoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction（UPJO） in children. Method 60 children with UPJO from March 2012 to December 2014 were collected to clinical research, retroperitoneal laparoscopic pyeloplasty was performed in 30 cases（Group A）, and transumbilical single-site laparoscopic pyeloplasty was performed in 30 cases（Group B）. The operative time, intraoperative blood loss, duration of the urethral catheter time, the postoperative hospital stay and the pastoperative result were compared between the 2 groups. Results All operations were successful without conversion to open surgery. There are no significant differences in the intraoperative blood loss, duration of the urethral catheter time, the postoperative hospital stay and the postoperative result between two groups. However, group A has slightly longer operative time（138.1±15.1）min and shorter duration of the catheter time（1.3±0.4）d than those of operative time（96.7±10.2）min and catheter time（1.8±1.0）d. Group B injuried duodenum in one case, and group A did not appear. Conclusions Retroperitoneal and transumbilical single-site laparoscopic pyeloplasty in treatment of UPJO in children were safe and feasible, but transumbilical single-site laparoscopic has more operating space and better cosmetic effect.
作者
胡啸天
彭澎
段支前
HU Xiao-tian PENG Peng DUAN Zhi-qian(Department of Surgery, the People＇s Hospital of Yingshan, Hubei Yingshan, 438700, Chin)
出处
《发育医学电子杂志》
2016年第2期92-95,共4页
Journal of Developmental Medicine (Electronic Version)
关键词
腹腔镜肾盂成形术
后腹腔镜
经脐单部位腹腔镜
小儿肾积水
肾盂输尿管连接部梗阻
Laparoscopic pyeloplasty
Retroperitoneal laparoscopy
Transumbilical single-site laparoscopy
Pediatric hydronephrosis
Ureteropelvic junction obstruction
