后腹腔镜技术在上尿路疾病的临床应用

Clinical Application of Upper Urinary Tract Diseases by Retroperitoneal Laparoscopy

目的:比较应用后腹腔镜技术与开放手术对部分上尿路疾病的治疗,总结和提高后腹腔镜技术水平,逐步扩大后腹腔镜技术的适应证,为进一步治疗下尿路疾病奠定基础。方法:回顾性分析后腹腔镜组188例(A组),开放手术组139例(B组)资料,分别就手术时间、出血量、术后排气时间、术后住院日等进行比较,统计学t检验。结果:两组手术均顺利完成,疗效无差异(P>0.05),与开放手术组相比,后腹腔镜组术中及术后出血量、术后排气时间、术后住院日均明显减少(P<0.05),手术时间部分长于开放组,部分短于开放组。结论:上尿路疾病应用后腹腔镜技术,不会干扰和污染腹腔脏器,具有出血少、损伤小、痛苦少、康复快等优点。随着技术水平的不断提高,部分手术时间必将进一步缩短。在泌尿外科领域后腹腔镜技术将得到更加广泛的应用。

Objective：To review and analyze the application of retroperitoneal laparoscopy and open surgery in some upper urinary tract diseases, sum up clinical experience, and improve the skills of retroperitoneal laparoscopic surgery to gradually expand the application of laparoscopy in upper urinary tract diseases, and make base for treatment of lower urinary tract diseases. Methods：Retroperitoneal laparoscopic surgery was carried out in 188 cases （group A）, and open surgery was carried out in 139 cases （group B）. The two groups were compared in opertive time, blood loss, postoperative discharge time and postoperative hospital stay respectively. Results：Two operations were successfully completed, no difference in efficacy （ P 〉 0 . 05）, compared with open surgery, laparo scopic group, the intraoperative and postoperative bleeding, postoperative discharge time, postoperative hospital day significantly reduced （ P 〈0 . 05）, operative time longer than the open group some, some shorter than the open group. Conclusions： Treatment of upper urinary tract diseases by retroperitoneal laparoscopic technology is ad vanced in direct ways, not interfering with laparoscopic internal organs and the pollution, less blood loss, less damage, less pain, rapid recovery. With ongoing training, retroperitoneal iaparoscopic technology will shorten the operative time of some diseases, and will he more widely used in the whole field of urology in the future.