摘要
目的比较腹膜后途径3D腹腔镜与传统2D腹腔镜下肾盂成形术治疗肾盂输尿管交界处梗阻(UPJO)的技术特点和临床疗效。方法回顾性分析2014年6月至2016年9月郑州大学第一附属医院收治的92例行腹膜后途径腹腔镜下肾盂成形术患者的临床资料。按手术方法分为3D腹腔镜组(48例)和传统2D腹腔镜组(44例)。收集2组患者临床数据(年龄、性别、侧别、BMI)及围手术期数据(手术时间、术中出血量、术后胃肠通气时间、术后住院天数)。2组数据计量资料用t检验,计数资料用卡方检验。结果手术均采用腹膜后途径腹腔镜技术顺利完成,无中转开放手术病例。3D腹腔镜组手术时间(89.0±12.8)min,2D腹腔镜组手术时间(111.8±13.2)min,3D腹腔镜组手术时间明显缩短,两者比较有统计学差异(t=6.87,P<0.05);比较2组数据术中出血量、术后胃肠通气时间、术后住院天数无统计学差异(P>0.05)。以上患者均获得随访,随访时间5~30月,平均18个月。3D腹腔镜组病例和传统2D腹腔镜组病例术后肾积水均减轻,无再发狭窄病例,但2组各有1例患者发生术后吻合口漏尿。结论腹膜后途径3D腹腔镜下肾盂成形术治疗肾盂输尿管交界处梗阻是安全、有效、可行的。与传统2D腹腔镜相比,3D腹腔镜手术在深度层次和空间定位上有显著优势,可明显降低手术难度,缩短手术时间。
Objective To compare the clinical efficacy and technical features of retroperitoneoscopic three dimensional （3D） and traditional two dimensional （2D） pyeloplasty in the treatment of ureteropelvic junction obstruction （UPJO）. Meth- ods The clinical data of 92 patients who underwent retroperitoneoscopic pyeloplasty for UP30 during Jun. 2014 and Sep. 2016 in our hospital were retrospectively reviewed. The patients were divided into 2 groups：observation group （n = 48, received 3D retroperitoneoscopic pyeloplasty） and control group （n = 44, received traditional 2D retroperitoneoscopie pyeloplasty）. The demographic data （gender, age, laterality, BMI）, perioperative indexes and clinical outcomes （operation time, intraoperative blood loss,postoperative gastrointestinal recovery time, postoperative hospital stay） were compared between the 2 groups. The data were analyzed using t test and Chi-square test. Results All operations were successful,without conversion to open surgery. The operation time for the observation group and control group were （89.0±12.8） vs. （111.8 ±13.2） rain, with significant difference （t = 6.87, P〈0. 005）. There were no differences in intraoperative blood loss,postoperative gastrointestinal recovery time,and postoperative hospital stay between the 2 groups （P 〉 0. 05）. During the follow-up of 5- 30 months （mean 18 months）, all patients were cured and none recurrence occurred. However,in either group, there was 1 case of stomal leak. Conclusion Retroperitoneoscopic 3D pyeloplasty is safe,effective and feasible in the treatment of UPJO. Compared with traditional 2D laparoscopic technology, 3D technology has significant advantages in the depth and spatial orientation, and can reduce the operation difficulty and shorten the operation time.
作者
闫哲
王军
杨锦建
李松超
田迪
汪涛
耿一鹤
贾占奎
YAN Zhe WANG Jun YANG Jin-jian LI Song-chao TIAN Di WANG Tao GENG Yi-he JIA Zhan-kui(Department of Urology, Affiliated Hospital of Zhengzhou University, Institute of Urology of Henan Province,Tumor Molecular Biology Laboratory of Urology, Zhengzhou 450052 ,Chin)
出处
《现代泌尿外科杂志》
CAS
2017年第10期748-751,共4页
Journal of Modern Urology
