两种经脐腹腔镜肾盂成形术治疗儿童肾积水的疗效比较  

Comparison of two transumbilical laparoscopic pyeloplasties for treating ureteropelvic junction obstruction in children

作　　者：谢华伟[1] 周辉霞[1] 马立飞[1] 周晓光[1] 陶天[1] 王超[1] 李龙[2] 张旭[3] 

机构地区：[1]北京军区总医院附属八一儿童医院,100700 [2]首都儿科研究所 [3]中国人民解放军总医院

出　　处：《中华小儿外科杂志》2015年第10期732-735,共4页Chinese Journal of Pediatric Surgery

基　　金：北京市科技计划（Z111107067311062）;卫生部行业专项（201402007）

摘　　要：目的比较两种经脐人路腹腔镜。肾盂成形术治疗儿童肾盂输尿管连接部梗阻所致肾积水的手术效果。方法收集我院于2011年6月至2013年6月收治的285例肾积水患儿资料，其中经脐单孔腹腔镜手术120例（A组），经脐三通道腹腔镜手术165例（B组），比较两组在手术时间、术中估计出血量、术中并发症、留置引流管、术后恢复饮食时间、术后住院天数、手术成功率等方面的差别。结果手术均获得成功，无中转开放手术。A组和B组在手术时间（72．04±18．48）min比70．97±14．32）min、术中估计出血量（7．75±3．6）ml比（7．63±4．0）ml、术后住院时间（7．22±1．14）d比（7．06±1．09）d等方面差异均无明显统计学意义，而A组留置引流管时间（3．0±1．3）d比（2．89±1．18）d及术后恢复饮食时间（1．52±0．85）d比（1．33±0．65）d均略长于B组。结论两种经脐单孔腹腔镜。肾盂成形术治疗小儿肾积水均安全可行，但经脐三通道腹腔镜有微创、美容效果更好的优势。Objective To evaluate the effectiveness of two umbilical laparoscopic pyeloplasties in the treatment of pediatric hydronephrosis from ureteropelvic junction obstruction （UPJO）. Methods From June 2011 to June 2013, a total of 285 children with hydronephrosis were recruited to undergo either single-port transperitoneal laparoscopic pyeloplasty （group A,n = 120） or three-port operations （group B, n = 165）. The parameters of operative duration, intraoperative blood loss, duration of urethral catheterization time, postoperative hospital stay and inter-group postoperative outcomes were compared. Results All operations were successful without any conversion into open surgery. No significant differences existed in operative duration （72.04 ±18.48 vs 70.97 ±14.32 min）, intraoperative blood loss volume （7. 75± 3. 6 vs 7. 63 ± 4. 0ml）, postoperative hospital stay （7. 22 ± 1.14 vs 7. 06±1.09 days） and inter-group postoperative outcomes （98. 7% vs 98.8%）. However, group A had a slightly longer duration of urethral catheterization time （3. 0 ± 1.3 vs 2. 89 ± 1.18 days） and return to normal diet time （1.52 ±0. 85 vs 1.33±0. 65 days）. Conclusions Single-port and threeport transperitoneal laparoscopic pyeloplasty are both safe and Feasible in the treatment of pediatric hyd＇ronephrosis. However, the latter offers greater convenience and better cosmetics.

关 键 词：肾积水 腹腔镜检查 肾盂成形术 

分 类 号：R726.9[医药卫生—儿科]