小儿经脐单孔腹腔镜肾盂成形术经肠系膜途径与结肠旁途径的疗效比较  

Comparison of efficacy of transumbilical single-site laparoscopic pyeloplasty between transmesenteric and retrocolic approaches in children

作　　者：陶天 周辉霞 王超 马立飞 刘德鸿 周晓光 罗小龙 曹华林 TAO Tian ZHOU Hui-xia WANG Chao MA Li-fei LIU De-hong ZHOU Xiao-guang LUO Xiao-long CAO Lin-hua(Department of Urology, Bayi Children＇s Hospital AfIiliated to Chinese People＇s Liberation Army General Hospital, Beijing 100700, China)

机构地区：[1]陆军总医院附属八一儿童医院儿童泌尿外科,北京100700

出　　处：《发育医学电子杂志》2016年第3期165-168,共4页Journal of Developmental Medicine (Electronic Version)

基　　金：公益性卫生行业科研专项目(201402007);首都卫生发展科研专项基金(2016-2-5091);北京市科技计划(Z111107067311062)

摘　　要：目的比较小儿经脐单孔腹腔镜肾盂成形术经肠系膜途径与结肠旁途径的效果，评价经肠系膜途径的临床价值。方法回顾性分析2014年1月至12月，在陆军总医院附属八一儿童医院行经脐单孔腹腔镜肾盂成形术的肾盂输尿管连接部梗阻患儿资料，其中经肠系膜途径30例（A组），结肠旁途径45例（B组）。比较2组手术时间、术中出血量、术后肠道恢复时间、术后住院时间、并发症和成功率等指标。采用矿检验、成组t检验进行统计学分析。结果A组与B组的手术时间[（91．0±14．0）与（114．2±-10.3）分钟，t=2．378]、术中出血量[（8．3±2．2）与（15．9±2．8）ml，t=-1．991]、术后恢复饮食时间[（18．5±7．0）与（26．8±6．9）天，t=-1．782]和术后住院时间[（10．2±2．5）与（13．5±1．8）天，t=1．993]比较，A组均优于B组，差异有统计学意义（P值均〈0．05）。A组与B组手术成功率差异无统计学意义[96．7％（29／30）与95．6％（43／45），X^2=0．973，P〉0．05]。结论单孔腹腔镜经肠系膜途径肾盂成形术可安全有效治疗肾盂输尿管连接部梗阻。Objective To compare the efficacy of transumbilical single-site laparoscopic pyeloplasty between transmesenteric and retrocolic approaches in children, and to assess the value of transmesenteric approach. Methods From January to December 2014, the clinical data of patients with ureteropelvic junction obstruction who received transumbilical single-site laparoscopic pyeloplasty were analyzed in Bayi Children＇s Hospital. There were 30 cases in the transmesenteric approach group （group A） and 45 cases in the retrocolic approach group （group B）. The operation time, perioperative bleeding, postoperative intestinal recovery time, postoperative hospital stay, incidence of postoperative complications and rate of successful operation were compared between the two groups. Chi-square test and group t test were used for statistical analysis. Results In group A and group B, there were statistical difference about the operation time [ （91.0 ± 14.0） vs （114.2 ± 10.3） rain, t=-2.378 ] , perioperative bleeding [ （8.3 ± 2.2） vs （15.9 ± 2.8） ml, t=1.991 ] , postoperative intestinal recovery time [ （18.5± 7.0） vs （26.8 ± 6.9） d, t=1.782 ] , and postoperative hospital stay [ （10.2 ± 2.5） vs （13.5± 1.8） d, t=1.993 ], and the results of group A were better than those in group B （all P〈0.05）. There was no statistical difference about the rate of successful operation [ 96.7%（29/30） vs 95.6%（43/45）, X^2=0.973, P〉0.05 ] . Conclusions Transumbilical single-site laparoscopicpyeloplasty via transmesenteric is safe and effective for ureteropelvic junction obstruction.

关 键 词：单孔腹腔镜 肾盂成形术 儿童 经肠系膜 经结肠旁 

分 类 号：R726.5[医药卫生—儿科]