不同途径腹腔镜肾盂成形术的术式选择与疗效比较

Operation choosing and efficacy comparsion of different approaches to laparoscopic pyeloplasty

目的探讨腹腔镜肾盂成形术的路径选择及其疗效比较。方法将126例肾盂输尿管连接部狭窄患者按手术路径不同分为经腹膜后组与经腹腔组,按狭窄位置的高低分为高位狭窄组和低位狭窄组,比较各组在缝合时间、手术时间、中转开放手术例数、出血量、术后并发症、住院时间等方面的差别。结果经腹腔组及经腹膜后组,在手术出血量、并发症、及出院时间等方面,两组比较无显著性差异,但在低位狭窄组,经腹腔组在缝合时间、手术时间及中转开放手术例数等方面明显好于经腹膜后组。结论经腹腔或腹膜后径路,均各有优势,应视术者的技术掌握情况和患者的特殊情况来决定入路方式。对于低位肾盂输尿管连接部梗阻患者,推荐使用经腹腔入路。

Objective To study the efficacy of laparoscopic pyeloplasty path selection and comparison. Methods The 126 cases of renal pelvis ureter stenosis patients were divided into via retroperitoneal group and the abdominal cavity by operation path connection department, and divided into high narrow group and the low group according to the narrow position. Their differences are compared between groups in suture time, operation time, cases transited open surgery, amount of bleeding, postoperative complication and hospital stays. Results The retroperitoneal group and the abdominal cavity have no significant difference in surgery, blood loss, complications, and discharge time, etc. But in the narrow group in the low post, the abdominal cavity are much better than the retroperitoneal group in open suture time, operation time and transit mode, etc. Conclusion Both of the retroperitoneal group and the abdominal cavity have their own advantages, performer should regard his technology and the patient＇s special circumstances to decide in the way. For low UPJO patients, it is recommended to use the abdominal cavity into operation.