后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床效果分析

Analysis of the clinical effect of retroperitoneal laparoscopic dismembered pyeloplasty in the treatment of ureteropelvic junction obstruction

目的探讨后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床效果分析。方法将2010年3月~2016年3月在我院外科治疗的60例肾盂输尿管连接部梗阻患者随机分为两组,对照组采用开放性离断式肾盂成形术,观察组采用后腹腔镜离断式肾盂成形术,比较两组患者的各项手术指标、术后并发症发生率、随访症状改善情况。结果观察组手术时间、术中出血量、肠胃功能恢复时间、下床活动时间、术后止痛药物使用量、住院时间均明显少于对照组,差异有统计学意义(P<0.05);观察组术后尿漏、切口感染、吻合口狭窄等并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后肾积水改善率明显高于对照组,肾积水复发率明显较低,差异有统计学意义(P<0.05)。结论后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床效果显著,对患者的创伤小、术后恢复快,且并发症少、术后复发率低,具有积极的临床意义。

Objective To investigate the clinical effect of retroperitoneal laparoscopic dismembered pyeloplasty in the treatment of ureteropelvic junction obstruction. Methods 60 patients with ureteropelvic junction obstruction who were treated in the surgery department in our hospital from March 2010 to March 2016 were randomly divided into two groups. The control group was given open dismembered pyeloplasty, and the observation group was given retroperitoneal laparoscopic dismembered pyeloplasty. The surgical indicators, postoperative complications, improvement of follow-up symptoms were compared between the two groups. Results The operation time, intraoperative blood loss, recovery time of gastrointestinal function, time of off-bed activity, postoperative analgesic drug use and length of stay in the observation group were significantly less than those in the control group, and the differences were statistically significant（P〈0.05）; the incidence rates of complications such as urinary leakage, incision infection and anastomotic stenosis in the observation group were significantly lower than those in the control group, and the differences between groups were statistically significant （P〈0.05）. The rate of improvement of hydronephrosis in the observation group was significantly higher than that in the control group, and the recurrence rate of hydronephrosis was significantly lower. There was significant difference between the two groups （P〈0.05）. Conclusion The clinical effect of retroperitoneal laparoscopic dismembered pyeloplasty in the treatment of ureteropelvic junction obstruction is significant. The trauma on the patients is less, the postoperative recovery is faster, the complications are fewer, and the postoperative recurrence rate is lower, which has a positive clinical significance.