经脐三通道腹腔镜下肾盂成形术治疗肾盂输尿管连接部位梗阻患儿的临床研究

Clinical Study of Transumbilical Three-channel Laparoscopic Pyeloplasty for the Treatment of Ureteropelvic Junction Obstruction in Children

目的:探讨不同手术入路在腹腔镜肾盂成形术治疗儿童肾盂输尿管连接部梗阻性肾积水的效果。方法:回顾性分析江西省儿童医院2019年6月-2020年6月收治的90例肾盂输尿管连接部位梗阻患儿资料,其中56例采用传统腹腔镜手术治疗设为A组,34例采用经脐三通道腹腔镜下手术治疗设为B组。记录并比较两组手术时间、术中出血量,观察两组手术前后肾盂肾盏分离情况,比较两组术后肾盂前后径及患侧分肾功能。结果:B组手术时间、术中出血量与A组比较均有所增加,但差异均无统计学意义(P>0.05)。B组肾盂分离、肾盏分离与A组比较均有所减少,但差异均无统计学意义(P>0.05)。B组术后肾盂前后径与患侧分肾功能与A组比较,差异均无统计学意义(P>0.05)。结论:经脐三通道腹腔镜治疗输尿管肾盂连接部位梗阻患儿具有较好治疗效果,与常规腹腔镜手术相比,开孔部位均在脐部,术后瘢痕较为集中。

Objective:To investigate the difference of surgical approach in laparoscopic pyeloplasty on obstructive hydronephrosis in children.Method:The data of 90 children with ureteropelvic junction obstruction treated in Jiangxi Children’s Hospital from June 2019 to June 2020 were analyzed retrospectively,of which 56 cases were treated with traditional laparoscopic surgery as group A and 34 cases were treated with transumbilical three-channel laparoscopic surgery as group B.The operation time and intraoperative bleeding were recorded and compared between the two groups,the separation of renal pelvis and calyces before and after operation was observed.the anterior and posterior diameter of renal pelvis and renal function of the affected side were compared between the two groups.Result:The operative time and intraoperative blood loss of group B were increased compared with group A,but the differences were not statistically significant(P>0.05).Compared with group A,the separation of renal pelvis and calyces in group B was decreased,but the differences were not statistically significant(P>0.05).There were no significant differences in postoperative renal pelvis diameter and affected side renal function between group B and group A(P>0.05).Conclusion:Three-channel umbilical laparoscopic treatment of children with ureteric renal pelvis junction obstruction has a good therapeutic effect.Compared with conventional laparoscopic surgery,the perforation site is in the umbilical cord,the postoperative scar is more concentrated.