经脐小通道与传统通道在成人腹腔镜肾盂成形术中的临床效果比较  

Comparison between transumbilical small-port and conventional port placement for laparoscopic pyeloplasty in adults

作　　者：陈炜[1] 成康 吴大鹏[1] 张盼[1] 杨志尚[1] 曾津[1] 王迎 CHEN Wei;CHENG Kang;WU Dapeng;ZHANG Pan;YANG Zhishang;ZENG Jin;WANG Ying(Department of Urology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2022年第11期949-953,957,共6页Journal of Modern Urology

摘　　要：目的比较和探讨经脐小通道与传统通道腹腔镜肾盂成形术治疗成人肾盂输尿管连接部梗阻(UPJO)所致肾积水的临床结果和美容效果。方法收集于2019年6月-2020年5月在西安交通大学第一附属医院因单侧UPJO行经腹腔途径腹腔镜肾盂成形术的患者资料,按照手术切口的不同,分为传统通道组(33例)和经脐小通道组(20例),比较两组在围手术期结果、手术成功率及美容学评分(POSAS量表和SCAR量表)等方面的差异。结果所有手术均成功实施,无中转开放手术者,两组在手术时间、出血量、术后并发症、留置引流管时间及成功率等方面无明显差异(P>0.05)。传统通道组吻合时间明显短于经脐小通道组[(41±10)min vs.(48±11)min,P=0.04]。而经脐小通道组的美容效果明显优于传统通道组。结论经脐小通道技术可安全、有效地应用于成人的腹腔镜肾盂成形术,功能学效果与传统通道腹腔镜手术类似,但美容效果更佳。Objective To compare the clinical efficacy and cosmetic results between transumbilical small-port and conventional port placement of laparoscopic pyeloplasty in the treatment of hydronephrosis caused by ureteropelvic junction obstruction(UPJO)in adults.Methods The clinical data of patients suffering unilateral UPJO treated with transperitoneal laparoscopic pyeloplasty during Jun.2019 and May 2020 in our hospital were collected.According to the surgical incisions,the cohort was divided into group of conventional port placement and group of transumbilical small-port placement.The perioperative outcomes,success rate and cosmetic scores(POSAS scale and SCAR scale)were compared between the two groups.Results All operations were successful without conversion to open surgery.There were 33 cases in the group of conventional port placement and 20 cases in the group of transumbllical small-port placement.There were no significant differences in operation time,blood loss,postoperative complications,drainage time and success rate between the two groups(P>0.05).Anastomosis time was notably shorter in the group of conventional port placement than in the group of transumbllical small-port placement[(41±10)min vs.(48±11)min,P=0.04].However,the cosmetic effects were remarkably better in the group of transumbllical small-port placement than in the group of conventional port placement.Conclusion Transumbilical small-port placement can be applied safely and effectively to laparoscopic pyeloplasty in adults.It harbors comparable functional results with conventional port placement,in addition to its better cosmetic effects.

关 键 词：腹腔镜肾盂成形术 通道建立 经脐小通道 肾积水 肾盂输尿管连接部梗阻 

分 类 号：R692[医药卫生—泌尿科学]