后腹腔镜治疗输尿管结石合并输尿管狭窄临床效果研究

The clinical effect observation of radical resection of the ladder combined with urinary diversion through 3D laparoscope

目的探讨后腹腔镜输尿管切开取石术治疗输尿管上段结石合并输尿管狭窄的临床疗效。方法选取输尿管上段结石合并输尿管狭窄的患者48例,随机分为后腹腔镜组以及输尿管镜组,后腹腔镜组给予后腹腔镜输尿管切开取石术以及输尿管狭窄切除吻合术,而输尿管镜组给予输尿管镜钬激光碎石术疗法,对比两组患者术中以及术后各项指标的差异。结果两组患者手术时间以及术后住院时间对比差异不具有统计学意义,输尿管镜组患者的术中出血量明显低于后腹腔镜组,而后腹腔镜组的术后并发症发生率显著低于输尿管镜组,同时一次性手术取尽结石率明显高于输尿管镜组,并且解除输尿管狭窄症状成功率也显著高于输尿管镜组,差异均具有统计学意义(P<0.05)。结论后腹腔镜输尿管切开取石术治疗输尿管上段结石疗效显著,安全可靠,同时治疗输尿管狭窄还具有明显优势,得到更加有效的预防结石复发。

Objective:To invtestigate the clinical effect of radical resection of the ladder combined with urinary diversion through 3D laparoscope.Methods:198 patients with the bladder side wall of NMIBC,according to the method chosen for operation,were divided into two groups,there were 101 cases which underwent 3D laparoscopic thrapy,97 cases which received traditional laporotomy.The operation time,bleeding volume during operation,catheterization time,hospital stay,the rate of tumor recurrence and postoperative complication were compared.Results:As to operative index,compared with traditional laporotomy,3D laparoscopic thrapy had longer operation time,less bleeding volume during operation,shorter catheterization time and shorter hospital stay,the difference has significance(P<0.05).On the the rate of tumor recurrence and postoperative complication,compared with traditional laporotomy,3D laparoscopic therapy has lower recurrence rate and less complications.Conclusion:On the therapy of ladder tumor,3D laparoscopic therapy is with lighter damage,better recovery state and less complications and shorter recovery periods,and there is obvious significance combared with traditional laporotomy.