3D与2D后腹腔镜输尿管切开取石的手术效果比较  

Comparison of the effect of three-dimensional versus two-dimensional retroperitoneal laparoscopic ureter lithotomy

作　　者：陈庆科[1] 刘久敏[1] 冼志勇[1] 徐战平[1] 罗耀雄[1] 陈汉忠[1] 叶楚津[1] 

机构地区：[1]广东省人民医院//广东省医学科学院泌尿外科,广东广州510080

出　　处：《南方医科大学学报》2016年第1期148-150,共3页Journal of Southern Medical University

摘　　要：目的探讨3D腹腔镜在输尿管切开取石手术的手术效果及其优劣势。方法收集2014年1月~2015年5月在我院行输尿管切开取石患者45例,通过简单随机分为3D腹腔镜25例,2D腹腔镜20例。对于手术过程进行片段式的模块切割统计,对每一步骤的耗时进行独立统计分析。对比分析术中术野暴露时间、放管时间、缝合时间等手术操作指标。结果 45例患者均手术成功,术后3.0±0.8 d拔除伤口引流管,术后1周拔除尿管出院,术后1个月膀胱镜拔除双J管,随访3月,复查IVP（静脉泌尿系造影）未见输尿管吻合口狭窄。手术步骤的模块耗时分析显示,3D组的每一关键操作步骤均比2D的耗时要少,且均优于2D组,统计学均有意义（P〈0.05）。3D腹腔镜在手术精细操作过程中明显优于2D组,3D立体感给予术者如开放手术般的纵深感觉,使抓持及缝合进针、绕线等精细操作的流畅度得到提高,从而缩短了手术操作时间。结论 3D腹腔镜作为新技术应用于外科微创手术当中,不仅给患者带来了微创的获益,而且使术者在舒适操作、快速响应及精细操作方面均有获益。Objective To compare the surgical effect of three- dimensional（3D） versus 2D laparoscopic surgery in ureter lithotomy. Methods From January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to undergo ureter lithotomy under 3D laparoscopy（25 cases） and 2D laparoscopy（20 cases）. The time used for each surgical process（including the exposure, D- J tube discharge, suture and other surgical procedures） was recorded and compared between the two groups. Results The operation was completed smoothly in all the 45 patients. In this cohort, the wound drainage tube was removed in a mean of 3.0 ± 0.8 days after the operation, the catheter was removed after a week, and the double J tube was removed at 1 month. Follow- up intravenous pyelography at 3 months after the operation reveal ureteral stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was significantly shorter in the 3D group than in the 2D group（P0.05）. 3D laparoscopic surgery allowed more precise operation by providing a good sense of depth as in an open surgery to reduce the operation time. Conclusion As a minimally invasive surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in ureter lithotomy.

关 键 词：3D 后腹腔镜 输尿管切开取石 

分 类 号：R699[医药卫生—泌尿科学]