连续缝合技术在后腹腔镜输尿管切开取石术中的临床应用  

Clinical application of continuous suture technique in retroperitoneoscopic ureterolithotomy

作　　者：张剑平[1] 邓超雄[1] 林荣凯[1] 葛亮[1] 庄惠强[1] 洪梓煌 杨朝裕 潘润阳[1] 徐航[1] 

机构地区：[1]华侨大学附属海峡医院泌尿外科,福建泉州362000

出　　处：《临床泌尿外科杂志》2017年第4期303-305,共3页Journal of Clinical Urology

摘　　要：目的:比较后腹腔镜输尿管切开取石术中"连续缝合技术"和"间断缝合技术"的临床应用。方法:回顾性分析2012年5月~2016年4月在我院行后腹腔镜输尿管切开取石术的112例输尿管结石患者的临床资料。根据术中输尿管吻合方法不同,分为连续缝合组52例(A组)和间断缝合组60例(B组)。比较两组患者的结石大小、体重指数、总手术时间、输尿管缝合时间、缝合针数、术中出血量、术后住院时间、引流管拔出时间及漏尿及输尿管狭窄等并发症发生率。结果:112例手术均获成功。两组患者结石大小及体重指数等一般资料比较差异无统计学意义。A组平均手术时间为53.5min,明显低于B组的手术时间65.7min(P<0.05),其中输尿管缝合时间为10.5min,低于B组的输尿管缝合时间18.9min(P<0.05)。两组患者缝合针数、术中出血量、术后住院时间、引流管拔出时间等比较差异无统计学意义。A组围手术期无漏尿病例,B组围手术期漏尿2例。随访3~9个月,两组患者肾输尿管积水明显改善,均未发现输尿管狭窄等并发症。结论:后腹腔镜输尿管切开取石术中应用连续缝合技术可降低输尿管缝合难度、缩短手术时间、减少术后尿漏发生率。Objective：To compare the clinical application between ＂continuous suture＂and ＂interrupted suture＂in retroperitoneoscopic ureterolithotomy.Method： We retrospectively analyzed the clinical data of 112 paritents with ureteral calculus who were treated with retroperitoneoscopic ureterolithotomy from May 2012 to April 2016 in our hospital.The patients were divided into group A（52with continuous suture）and group B（60with interrupted suture）.We compared their calculus size,body mass index,total time of operation,time for ureter suture,the number of stitches of suture,amount of blood loss during operation,hospital stay after operation,time to pull out the drainage tube and complication rate of leakage of urine and ureterostenosis,etc.according to methods of ureter anastomosis during operation between two groups.Result：All operations were successful.There was no significant difference between these two groups in calculus size,body mass index or other general information.The average operative time of group A（53.5mins）was significantly shorter than that of group B（65.7mins）（P〈0.05）,and the average time for ureter suture of group A（10.5 mins）was significantly shorter than that of group B（18.9mins）（P〈0.05）.However,there was no significant difference in the number of stitches of suture,amount of blood loss during operation,hospital stay after operation or time to pull out the drainage tube between the two groups.There was no leakage of urine in group A in perioperative period,while two cases in group B occurred.During the follow-up visit of 3-9months,hydroureter was significantly improved in patients of two groups,and no ureterostenosis or other complications was found.Conclusion：The application of continuous suture in retroperitoneoscopic ureterolithotomy can reduce the difficulty of ureter suture,shorten the operation time and reduce the incidence of postoperative leakage of urine.

关 键 词：腹腔镜 输尿管 结石 

分 类 号：R699[医药卫生—泌尿科学] R693.4[医药卫生—外科学]