标准和单孔后腹腔镜术式治疗老年输尿管上段结石疗效及安全性比较

Clinical effects and safety comparison of standard and single-port retroperitoneal laparoscopic surgery in the treatment of patients with upper ureteral calculi

目的探讨标准和单孔后腹腔镜术式对老年输尿管上段结石患者疗效及安全性的影响。方法回顾性分析2014年4月至2016年4月在本院收治的老年输尿管上段结石患者共120例的临床资料,根据手术方案不同分为标准组(60例)和单孔组(60例),采用标准或单孔后腹腔镜术式治疗。比较两组患者取石成功率、围手术期临床指标、临床治疗满意度、切口美观性评分及术后并发症发生率等。结果两组患者取石成功率比较差异无统计学意义(P>0.05);两组患者手术时间比较差异无统计学意义(P>0.05);单孔组患者术中出血量、术后肛门排气时间、术后引流量、术后拔管时间及住院时间均显著优于标准组(P<0.05);单孔组患者临床治疗满意度和切口美观性评分均显著高于标准组(P<0.05);单孔组患者术后并发症发生率显著低于标准组(P<0.05)。结论单孔后腹腔镜术式用于老年输尿管上段结石患者治疗可有效减少手术创伤,加快术后康复进程,提高治疗满意度和切口美观性,且有助于降低并发症发生风险,价值优于标准式后腹腔镜手术。

Objective To investigate the influence of standard retroperitoneal laparoscopic surgery and single-port retroperitoneal laparoscopic surgery on clinical effects and safety of patients with upper ureteral calculi.Methods From April 2014 to April 2016,120 elderly patients with upper ureteral calculi were chosen in our hospital and randomly divided into two groups including standard group(60 patients)with standard retroperitoneal laparoscopic surgery and single-port group(60 patients)with single-port retroperitoneal laparoscopic surgery,and the success rate of stone extraction,the perioperative clinical index,the clinical treatment satisfaction degree,the aesthetic score of incision and postoperative complications incidence of both groups were compared.Results There was no significant difference in the success rate of stone extraction between two groups(P>0.05).There was no significant difference in the operation time between two groups(P<0.05).The volume of intraoperative blood loss,the postoperative anal exhaust time,the postoperative drainage volume,the postoperative extubation time,hospital staying time of single-port group were significantly better than standard group(P<0.05).The clinical treatment satisfaction degree and the aesthetic score of incision of single-port group were significantly higher than standard group(P<0.05).The postoperative complications incidence of single-port group were significantly lower than standard group(P<0.05).There was no significant difference in the incidence of postoperative complications between two groups(P<0.05).Conclusions Compared with standard retroperitoneal laparoscopic surgery,single-port retroperitoneal laparoscopic surgery in the treatment of elderly patients with upper ureteral calculi can efficiently decrease the surgical trauma degree,accelerate the recovery process after surgery,improve the treatment satisfaction and incision aesthetic and be helpful to reduce the complications risk.