4K超高清和常规高清腹腔镜治疗肾盂输尿管连接处梗阻的对比研究  

Comparison between 4K ultra-high definition and high-definition laparoscopy for the treatment of ureteropelvic junction obstruction

作　　者：陈龙[1] 顾朝辉[1] 冯勇杰 赵科元 周乃春 樊瑞新 窦晨阳 张少朋 Chen Long;Gu Chaohui;Feng Yongjie;Zhao Keyuan;Zhou Naichun;Fan Ruixin;Dou Chenyang;Zhang Shaopeng(Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,450052

出　　处：《中华实验外科杂志》2020年第10期1912-1914,共3页Chinese Journal of Experimental Surgery

摘　　要：目的:探讨4K超高清(UHD)腹腔镜进行肾盂成形术治疗肾盂输尿管连接处梗阻(UPJO)的安全性、有效性及优势。方法:收集2018年6月至2019年6月期间郑州大学第一附属医院收治UPJO患者60例,根据在不同腹腔镜下行肾盂成形术,将患者分为UHD组(n=30)及常规高清(HD)组(n=30)。收集两组患者的临床数据(性别、年龄、体重指数、肾积水程度)及围术期数据(手术时间、术中出血量、肾周引流量、引流时间及术后住院时间)。计量资料采用t检验或秩和检验,计数资料采用χ2检验。结果:60例患者手术均成功,无中转开放手术,HD组和UHD组的人口特征差异无统计学意义(P>0.05)。HD组和UHD组的手术时间为(114.800±11.047)min比(107.500±8.423)min,差异有统计学意义(t=2.878,P<0.05);出血量为(35.330±11.059)ml比(29.670±10.417)ml,差异有统计学意义(t=2.043,P<0.05)。HD组和UHD组其他围术期数据分别为:肾周引流量(45.670±8.172)ml比(44.000±7.589)ml;引流时间(3.270±0.944)d比(3.270±0.980)d;术后住院时间(7.230±0.430)d比(7.070±0.521)d,差异无统计学意义(t=0.819、0.000、1.351,P>0.05)。60例患者均进行1年的术后随访,UHD组及HD组患者术后症状消失,且均无再梗阻患者,不需再次行肾盂成形术或留置双J管。HD组术后少量漏尿1例,1周后自愈。UHD组术后泌尿系感染1例,予以抗生素应用后症状好转。结论:4K-UHD腹腔镜及HD腹腔镜系统下肾盂成形术具有相同的安全性与有效性。与HD腹腔镜系统比较,4K-UHD腹腔镜系统的优势体现在缩短了手术时间,减少了术中失血量。Objective To explore the safety,effectiveness and advantages of 4K ultra-high definition(UHD)laparoscopy for the treatment of ureteropelvic junction obstruction(UPJO).Methods Medical data of 60 patients who treated UPJO by laparoscopy pyeloplasty using an high definition(HD)or UHD system from June 2018 to June 2019 were reviewed in the first affiliated Hospital of Zhengzhuo University.According to different laparoscopic systems,they were divided into UHD group(n=30)and HD group(n=30).Their clinical data(sex,age,BMI,degree of hydronephrosis)and perioperative data(operation time,blood loss,drainage volume,drainage time and hospital stay)were collected and analyzed.Results 60 cases of LP were successful and there was no conversion to open operation.There was no difference in characteristics between two groups.The operation time of HD group and UHD group was(114.800±11.047)min vs.(107.500±8.423)min,t=2.878,P<0.05),and the difference of blood loss was(35.330±11.059)ml vs.(29.670±10.417)ml,t=2.043,P<0.05).Other perioperative data of HD group and UHD group were no difference between two groups:abdominal drainage(45.670±8.172)ml vs.(44.000±7.589)ml;time of drainage(3.270±0.944)d vs.(3.270±0.980)d;Hospital stay(7.230±0.430)d vs.(7.070±0.521)d(t=0.819,0.000,1.351,P>0.05).All the 60 patients were followed up for 1 year.A small amount of urine leakage occurred in the HD group,which recovered after 1 week.Postoperative urinary tract infection occurred in 1 case in the UHD group,and the symptoms improved after antibiotic application.Conclusion 4K-UHD laparoscopic pyeloplasty and HD laparoscopic pyeloplasty have the same safety and efficacy.4K-UHD laparoscopic surgery shortens the operation time and reduces the amount of blood loss during operation.

关 键 词：4K超高清腹腔镜 肾盂成形术 肾盂输尿管连接处梗阻 

分 类 号：R699[医药卫生—泌尿科学]