后腹腔镜与开放性肾折叠固定术治疗巨大肾积水的疗效比较

Comparison of retroperitoneoscopy and open nephroplication nephropexy for giant hydronephrosis

目的评价后腹腔镜肾折叠固定术在巨大肾积水治疗中的临床价值。方法回顾分析后腔镜肾折叠固定术36例(A组)与开放性肾折叠固定术32例(B组)患者的临床资料,比较两种术式手术时间、术中出血量、术后肠功能恢复时间、止痛药使用时间、术后放置腹膜后引流管时间、术后留置导尿时间、术后平均住院时间、术后恢复正常工作时间、并发症及临床疗效等指标。结果两组手术时间、术后肠功能恢复时间、术后放置腹膜后引流管时间、术后留置导尿时间、并发症及临床疗效等比较,差异无显著性(P>0.05);但A组术中出血量、止痛药使用时间、术后平均住院时间及术后恢复正常工作时间均少于B组(P<0.05)。结论后腹腔镜肾折叠固定术与开放手术疗效相似,但创伤小、疼痛轻、恢复快,可作为巨大肾积水保肾治疗的一线选择。

【Objective】To evaluate retroperitoneoscopic nephroplication and nephropexy for giant hydronephro-sis.【Methods】Clinical data of 36 cases who underwent retroperitoneoscopic nephroplication and nephropexy（A group） were retrospectively compared with those of 32 who underwent open surgery（B group）,including the mean operative time,blood loss,postoperative recovery of intestinal function,the time of pain killers used,the duration of retroperitoneal drainage tube reservation,the duration of urethral catheter reservation,the average hospital stay,the recovery days,complications and the therapeutic effect.【Results】There were no significant difference in the mean time postoperative recovery of intestinal function,the duration of retroperitoneal drainage tube and urethral catheter reservation,complications and the therapeutic effect between the two groups（P 0.05）.The blood loss,the duration of pain killers used,the average hospital stay and the recovery days in A group showed significant advantages than those in B group（P 0.05）.【Conclusions】The therapeutic effect of retroperitoneoscopic nephroplication and nephropexy was similar with the renal open surgery and it was the first choice for advantages of less trauma,less pain and quicker recovery.