单孔后腹腔镜与标准后腹腔镜输尿管切开取石术的对比研究  

Comparative study of retroperitoneal laparoendoscopic single-site and standard laparoscopic ureterolithotomy

作　　者：欧阳松[1] 王勤章[1] 丁国富[1] 李强[1] 倪钊[1] 李应龙[1] 王新敏[1] 王文晓[1] 

机构地区：[1]石河子大学医学院第一附属医院泌尿外科,新疆石河子832008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2013年第5期24-27,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：2011年兵团科技攻关项目(基金项目号2011BA036)

摘　　要：目的探讨单孔后腹腔镜输尿管切开取石术的有效性、安全性及可行性。方法回顾性分析2011年7月至2012年7月输尿管结石患者27例，其中行单孔后腹腔镜输尿管切开取石术（单孔组）12例，行标准后腹腔镜（标准组）15例，比较两组的手术效果。结果27例手术均成功，无中转标准腹腔镜或开放手术，术中所有结石均成功取出，无明显术中并发症发生，两组在术中出血量、术后肠道恢复时间、术后引流量、术后拔管时间、术后住院天数上差异无统计学意义（t=3．856，P〉O．05），而单孔组在手术时间上长于标准组（P〈0．05）。两组均无明显术后并发症发生。标准组有1例患者术后第2天使用镇痛药物，单孔组未使用镇痛药物，患者满意度及术后美容效果上单孔组反映良好，所有患者术后随访1～3个月未发现输尿管梗阻或狭窄。结论单孔后腹腔镜输尿管切开取石术是安全可行的，美容效果好，但手术难度较大。Objective To explore the efficacy, safety and feasibility of retroperitoneal laparoendoscopic single-site （LESS） ureterolithotomy. Methods From July 2011 to July 2012, the data of 27 patients with ureteral calculi, divided into single-site group （n=12） and standard group （n=15）, were compared. Results All the operations were completed successfully, without conversion to standard laparoscopic or open surgery. All stones were successfully removed and no intraoperative complication occurred. Drainage volume, drainage removal duration, blood loss, postoperative bowl function recovery time and postoperative hospital stay were compared, the two groups had no significant difference （P〉O.05）. Operative time in single-site group was much longer than standard group （t=-3.856, P〈0.05）. No major postoperative complication occurred in neither group. One patient used analgesics the second day after operation in standard group, single-site group did not use analgesics. Patient＇s satisfaction and postoperative cosmetic results were superior in single-site group. All patients showed no ureteral obstruction or stricture after 1-3 months＇ follow-up. Conclusions Retroperitoneal LESS ureterolithotomy is safe and feasible, but it＇s difficult.

关 键 词：单孔 腹腔镜 输尿管 结石 手术 

分 类 号：R699[医药卫生—泌尿科学]