腹腔镜手术与开放性肾盂输尿管切开取石的比较

A comparative study of laparoscopic and retroperitoneal laparoscopic pyeloureterolithotomy with open pyeloureterolithotomy

目的评价经腹腔镜、后腹腔镜与开放性肾盂输尿管切开取石术的临床价值。方法对12例经腹腔镜、20例经后腹腔镜和35例开放性肾盂输尿管切开取石术的临床资料进行统计分析,比较三种方法的手术时间、术中失血量、引流管放置时间和住院天数等的差别。结果后腹腔镜组和开放手术组手术全部成功,腹腔镜组有1例因为结石上移入肾内而改为开放手术。三组手术时间和引流管放置时间无明显差异(P>0.05);后腹腔镜组及腹腔镜组术中失血量和住院天数均显著低于开放手术组(P<0.01),其中后腹腔镜组术中失血量还显著低于及腹腔镜组(P<0.05),但两组住院天数无明显差异(P>0.05)。结论腹腔镜及后腹腔镜治疗肾盂输尿管结石具有微创、出血少、恢复快而又安全有效的特点,其中后腹腔镜相对更具优势。

Objective To evaluate the clinical value of laparoscopic, retroperitoneal laparoscopic and open pyeloureterolithotomy.Methods The clinical data of 1.2 cases of laparoscopic pyeloureterolithotomy （LP）,20 cases of retroperitoneal laparoscopic pyeloureterolithotomy （RP）and 35 cases of open pyeloureterolithotomy （OP）were analysed.The difference of the three groups on operation time,average bleeding volume during operation, drain time and hospitalization duration were compared. Results All of the RP and OP operations were successful and only one case of LP was changed to the open operation. There were no significant difference on operation time and drain time of the three groups （P〉0.05）;the average bleeding volume during operation and hospitalization duration of LP and RP were significantly lower than those of OP（P〈0.01）; in addition, the average bleeding volume during operation of RP was significantly lower than that of LP（P〈0.05）, but there were no significant difference on hospitalization duration between the two groups（P〉0.05）.Conelusions LP and RP are two safe and effective operation methods with miniinvasion, little bleeding and short reoperation time, and RP has more advantages alternative to LP