经腹腔途径与经腹膜后途径腹腔镜下治疗肾盂输尿管连接部梗阻的临床对比分析

Comparison between transperitoneal laparoscopic pyeloplasty and retroperitoneoscopic pyeloplasty for ureteropelvic junction obstruction

目的对比经腹腔途径与腹膜后途径腹腔镜下治疗肾盂输尿管梗阻(UPJO)的手术时间、手术并发症及长期随访临床疗效。方法将2010年-2012年收治的UPJO患者共计80例随机分组,分别行经腹腔途径腹腔镜下肾盂成形术(TPLP)40例,行经腹膜后途经腹腔镜下肾盂成形术(RPLP)40例,比较两组手术时间、手术并发症及长期随访临床疗效。结果 RPLP组手术时间较TPLP组时间延长,差异有统计学意义(P<0.01),术后第一天疼痛视觉模拟评分法评分(VAS)、住院时间及不完全肠梗阻发生率TPLP组高于RPLP,平均随访(18.23±7.61)个月,TPLP组和RPLP组成功率分别为97.50%和95.00%,差异无统计学意义(P>0.05)。结论 RPLP虽手术时间较长,但住院时间短、术后并发症发生率较低,两组成功率相似,泌尿科医生易于接受RPLP。

【Objective】To compare the operation duration, complications, and efficacy of transperitoneal laparoscopic pyeloplasty（TPLP） versus retroperitoneal laparoscopic pyeloplasty（RPLP） for ureteropelvic junction obstruction（UPJO）.【Methods】From 2010 to 2012, 80 patients of UPJO were randomized into TPLP group and RPLP group, the operation duration, complications and clinical efficacy between two groups were compared.【Results】The mean operation time were higher in RPLP group than in TPLP group（P 0.01）. The visual analogue scale（VAS） score, hospital stay and the rate of ileus were higher in TPLP group. After a mean follow-up of（18.23±7.61） months, the success rate was 97.50% in TPLP group, 95.00% in RPLP group.【Conclusion】RPLP was associated with longer operative time, but shorter hospital stay and lower complications, the success rate remained the same. Urologists were easier to accept RPLP.