观察镜直接分离法在泌尿外科后腹腔镜手术中的应用效果研究

Effects of directly laparoscopic separation in urological retroperitoneal laparoscopic surgery

目的探讨观察镜直接分离法在泌尿外科后腹腔镜手术中的效果。方法选取2017年6月至2019年6月长葛市人民医院泌尿外科收治的60例行后腹腔镜手术的患者,男35例,女25例,年龄(45.12±12.65)岁,年龄范围为25~66岁,根据手术方式不同分为直接分离组与自制气囊组,每组30例。直接分离组采用观察镜直接分离法建立后腹腔行后腹腔镜手术,自制气囊组采用自制气囊法建立后腹腔行后腹腔镜手术,比较两组患者建立腹膜成功率、建立腹膜时间、造腔出血量、手术时长及术后并发症发生情况。结果直接分离组建立腹膜成功率[96.7%(29/30)]高于自制气囊组[73.3%(22/30)],建立腹膜时间[(6.26±1.21)min]、手术时长[(103.84±13.77)min]短于自制气囊组[(10.89±2.03)min、(126.45±15.65)min],造腔出血量[(4.22±1.65)ml]低于自制气囊组[(8.73±1.52)ml],并发症发生率[6.6%(2/30)]低于自制气囊组[26.7%(8/30)],差异均有统计学意义(P<0.05)。结论观察镜直接分离法在泌尿外科后腹腔镜手术中的临床效果显著,具有成功率较高、耗时较少、出血量较低、安全可靠等特点,值得在临床上推广应用。

Objective:To investigate the effects of directly laparoscopic separation in urological retroperitoneal laparoscopic surgery.Methods:Between June 2017 and June 2019,60 patients who underwent retroperitoneal laparoscopic surgery in the department of Urology at Changge People′s Hospital were enrolled in this study,including 35 males and 25 females,aged(45.12±12.65)years old,ranging from 25 to 66 years old.The patients were randomly divided into the direct separation group and self-made balloon group,with 30 cases in each group.In the direct separation group,the retroperitoneum was established by directly laparoscopic separation for retroperitoneal laparoscopic surgery,while in the self-made balloon group,the retroperitoneum was established by self-made gasbag for retroperitoneal laparoscopic surgery.The success rate and duration of retroperitoneum establishment,bleeding volume during cavity construction,operation duration,and the occurrence of postoperative complications were compared between the two groups.Results:The success rate of retroperitoneum establishment in the direct separation group was[96.7%(29/30)],higher than[73.3%(22/30)]in the self-made balloon group,the duration of retroperitoneum establishment and operation duration were[(6.26±1.21)minutes]and[(103.84±13.77)minutes],shorter than[(10.89±2.03)minutes]and[(126.45±15.65)minutes]in the self-made balloon group,and the bleeding volume during cavity construction was[(4.22±1.65)ml],less than[(8.73±1.52)ml]of the self-made balloon group,the incidence of complications in the direct separation group was[6.6%(2/30)],lower than[26.7%(8/30)]in the self-made balloon group,and the differences were statistically significant(P<0.05).Conclusion:Directly laparoscopic separation has significant clinical effects in urological retroperitoneal laparoscopic surgery.It is high success rate,less time-consuming,less bleeding,safe and reliable,which is worthy of clinical application.