腹膜后腹腔镜与开放性肾盂成形术治疗肾盂输尿管连接部狭窄的比较

A Comparison of the Effect Between Retroperitoneal Laparoscopic Pyeloplasty and Open Pyeloplasty

目的比较腹膜后腹腔镜与开放性肾盂成形术治疗肾盂输尿管连接部狭窄的疗效,探讨两种术式的适应证和技术要点。方法肾盂输尿管连接部狭窄患者27例,其中11例行腹膜后腹腔镜下肾盂成形术,16例行开放性肾盂成形术,两组术中均留置双J管。结果27例手术全部成功,术中无并发症发生。腹腔镜组和开放手术组的手术时间分别为(255±48)min、(150±40)min(P<0.05);出血量(55±8)ml、(100±10)ml(P<0.05);止痛剂(曲马多)用量(90±8)mg、(160±9)mg(P<0.05);术后住院时间(6±0.5)d、(11±0.6)d(P<0.05)。术后随访9～15个月,两组患者症状缓解,B超示积水减轻。结论腹腔镜下肾盂成形术安全、有效,较开放途径微创、术后恢复快,但它需要腹腔镜外科训练。

Objective To compare the efficacy of retroperitoneal laparoscopic pyeloplasty with open pyeloplasty and explore the indication snd major techniques. Methods 27 cases of uretercpelvic junction obstruction were enrolled in this study.11 and 16 patients underwent laparoscopic and open pyeloplasy, respectively. Double J struts were used in all cases. Results All the procedures were successfully completed.The average operation time was respectively （1.50 ± 40）min snd （2.55 ± 48）min in the laparoacopic group snd open group （ P 〈 0.05） ; averase bleeding volume was （55± 8）ml vs （100 ±10）ml （ P 〈 0.05） ;the dosage of analsesic （tramal） was （90± 8）mg and （160±9）mg （ P 〈0.05） and average bospi,pitalization time was （6 ± 0.5）days and （11± 0.6）days （ P 〈0.05）. Ultrasound B investigation showed that hydronephrosis reduced and symptom relieved in all cases during 9 to 15 months sfter operstion.Conclusion Laparoscopic pyeloplasty is safe and effective and associated with minimal trmma to the patient and a rapid recovery when compared with open pyeloplasty,However,it requires laparoscopic training.