经脐单孔腹腔镜和传统后腹腔镜重复肾半肾切除术治疗小儿重复肾输尿管畸形的病例配对研究  

Case-matched analysis of LESS versus retroperitoneal laparoscopic heminephrectomy for duplication anomalies in children

作　　者：周晓光[1] 周辉霞[1] 马立飞[1] 谢华伟[1] 陶天[1] 

机构地区：[1]北京军区总医院附属八一儿童医院泌尿外科,北京100700

出　　处：《微创泌尿外科杂志》2013年第5期309-312,共4页Journal of Minimally Invasive Urology

基　　金：北京市科技计划(Z11110706730000);中国博士后基金(201104901908)

摘　　要：目的:比较经脐单孔腹腔镜和传统后腹腔镜半肾切除术治疗小儿重复肾输尿管畸形的疗效。方法:将行单孔腹腔镜半肾切除术的35例患者资料与传统后腹腔镜半肾切除术20例患者资料进行配对,比较两组手术时间、术后住院时间、恢复正常饮食时间、术后并发症、围手术期超声检测结果及术后残余肾功能。结果:55例患者中位随访时间分别是12个月和24个月,术后恢复正常饮食的时间分别为(12.11±4.07)h(单孔组)和(8.93±1.31)h(传统后腹腔镜组)(P<0.05)。两组均无中转开放手术。早期的传统后腹腔镜组1例尿漏,通过7天的引流处理后自愈。单孔腹腔镜组和后腹腔镜组平均手术时间、术中出血量、术后住院时间的差异无统计学意义。两组均无并发症及死亡患者发生。两组术后均未发现下肾功能丧失,原发病的症状均改善。结论:对有经验的腹腔镜半肾切除术医生来说,经脐单孔腹腔镜半肾切除术是安全的,并取得了近似无瘢的美容结果。Objective:To compare the outcome of LESS and conventional laparoscopic Heminephrectomy treatment of children with duplex kidney.Methods:Period from April 2011to July 2013,implemented LESS Heminephrectomy in 35cases;and from June 2009to March 2011,retroperitoneal laparoscopic heminephrectomy for patient's age,sex,size,and surgeon paired 20patients were compared with operative time,postoperative hospital stay, time to resume normal diet,complications,perioperative and postoperative ultrasonic testing results of residual renal function.Results:The 55patients(LESS 35cases,20cases after conventional laparoscopic)were evaluated.Median follow-up time was 12months and 24months.Return to normal diet time was(12.11±4.07)h(LESS group) and(8.93±1.31)h(conventional laparoscopic group)(P<0.05).There were no conversion to open surgery. After the early conventional laparoscopic group one case of urinary leakage through drainage after 7days of treatment to heal.LESS group and conventional laparoscopic group,the average operation time,blood loss,postoperative hospitalization time difference was not statistically significant.There were no complications and patient deaths occurred. No renal function loss were found in both groups,the primary disease symptoms were all improved.Conclusions:To experienced laparoscopic Heminephrectomy doctors,LESS for Heminephrectomy is safe,and has achieved similar results without cosmetic scar.

关 键 词：经脐单孔 腹腔镜 半肾切除术 重复肾 

分 类 号：R692[医药卫生—泌尿科学]