肥胖对后腹腔镜肾切除治疗上尿路结石导致无功能肾的影响

Effects of obesity on the retroperitoneoscopic nephrectomy for non-functioning kidneys related to upper urinary calculi

目的分析肥胖对后腹腔镜肾切除治疗上尿路结石导致无功能肾的影响。方法443例上尿路结石导致无功能肾患者，按体质指数分为肥胖组251例，非肥胖组192例。均行后腹腔镜肾切除术。比较两组手术时间，术后平均血红蛋白下降量，住院时间，术中、术后并发症发生率。结果肥胖组手术时间为（124．25±46．52）分钟，非肥胖组为（103．25±40．76）分钟，两组比较差异有统计学意义（P〈0．05）；肥胖组住院时间、术后平均血红蛋白下降分别为（6．25±1．43）天和（15．75±14．28）g／L，非肥胖组分别为（5．89±1．27）天和（15．21±14．62）g/L，两组比较差异无统计学意义（P〉0．05）；肥胖组术中及术后早期并发症发生率分别为12．5％和6．3％，非肥胖组分别为7．6％和4．0％，两组比较差异无统计学意义（P〉0．05）。结论对于上尿路结石导致的无功能肾的肥胖患者，后腹腔镜肾切除是一种安全可行的手术方式，但手术时间延长。

Objective To investigate the effects of obesity on retroperitoneoscopic nephrectomy for non-functioning kidneys related to upper urinary calculi. Methods A total of 443 patients with non- functioning kidneys related to upper urinary calculi received retroperitoneoscopic nephrectomy, including 251 cases in the obese group and 192 cases in the non-obese group. Results The average operative time of the obese group was longer than the non-obese group [ （ 124.25 ± 46.52） min vs （ 103.25 ± 40.76） min,P 〈0.05 ]. The length of hospital stay and hemoglobin drop of the obese group were similar to those of the non-obese group [ （6.25 ± 1.43）d vs（5.89 ± 1.27）d,P 〉0. 05; （ 15.21 ± 14.62） g/L vs（ 15.75± 14.28 ） g/L, P 〉 0.05 ]. There was no significant difference between the groups in the incidence of intraoperative and postoperative complications （ 12.5 % vs 7.6%, P 〉 0.05 ; 6.3 % vs 4.0% , P 〉 0.05 ）. Conclusion Retroperitoneoscopic nephrectomy is safe and feasible for obese patients with non-functioning kidneys related to upper urinary calculi, but the operative time may be extended.