肾盂瓣在长段型输尿管狭窄手术中应用的疗效分析  

Efficacy of renal pelvis flap in surgery for long-segment ureteral stricture

作　　者：樊宏杰 杨艳芳[1] 花朝阳 院恩萌[1] 毕建朋 李梁斌 陈小朋 李星[1] 郭战[1] 张英[1] FAN Hongjie;YANG Yanfang;HUA Chaoyang;YUAN Enmeng;BI Jianpeng;LI Liangbin;CHEN Xiaopeng;LI Xing;GUO Zhan;ZHANG Ying(Department of Urology,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou,450018,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院泌尿外科,郑州450018

出　　处：《临床泌尿外科杂志》2023年第3期211-213,共3页Journal of Clinical Urology

基　　金：首都医学发展科研专项(No:2022-2-5083)。

摘　　要：目的:探讨肾盂瓣输尿管成形术的临床应用效果。方法:以2017年1月—2022年6月郑州大学附属儿童医院收治的526例肾盂输尿管连接处狭窄致肾积水患儿为研究对象,分为常规行经腹入路腹腔镜下Anderson-Hynes肾盂成形组(489例)、经腹入路腹腔镜下肾盂瓣输尿管成形组(37例),通过手术时间、术后腹腔引流管留置时间、术后住院时间、术后并发症、术后是否再次手术等评价指标,评价肾盂瓣输尿管成形术的疗效。结果:所有患儿从术后随访至2022年9月,随访时间3个月~5年。Anderson-Hynes肾盂成形组平均手术时间(128.6±17.3)min,术后平均腹腔引流管留置时间(3.6±1.2)d,出现腹腔引流管延期拔除46例,术后平均住院时间(9.2±2.6)d,术后有症状泌尿系感染72例,需再次手术者9例;肾盂瓣输尿管成形组平均手术时间(146.3±18.6)min,术后平均腹腔引流管留置时间(4.1±1.6)d,出现腹腔引流管延期拔除5例,术后平均住院时间(10.4±1.9)d,术后出现有症状泌尿系感染9例,需再次手术者1例。2组上述指标比较差异均无统计学意义(P>0.05)。结论:腹腔镜下肾盂瓣输尿管成形术与腹腔镜下Anderson-Hynes肾盂成形术在手术效果方面无明显差异,对于长段型肾盂输尿管连接处狭窄是一种切实可行的手术方式。Objective:To investigate the clinical efficacy of renal pelvis flap in ureteroplasty.Methods:A total of 526 patients with hydronephrosis caused by ureteropelvic junction stricture admitted to Children’s Hospital Affiliated to Zhengzhou University from January 2017 to June 2022 were selected as subjects,and divided into the routine transperitoneal laparoscopic Anderson-Hynes pyeloplasty group(n=489)and the transperitoneal laparoscopic renal pelvis flap ureteroplasty group(n=37).The efficacy of ureteroplasty with renal pelvis flap was evaluated by surgical duration,postoperative retention time of abdominal drainage tube,postoperative hospital stay,postoperative complications,and re-surgery rate.Results:All the patients were followed up from the end of surgery to September 2022,with a follow-up time ranging from 3 months to 5 years.In the routine surgery group,the average surgical duration was(128.6±17.3)min,and the postoperative retention time of the abdominal drainage tube was(3.6±1.2)d.Removal of the abdominal drainage tube was delayed in 46 patients,and the postoperative hospital stay was(9.2±2.6)d.Seventy-two patients presented symptomatic urinary tract infection after the surgery,and nine patients needed re-surgery.In the renal pelvis flap ureteroplasty group,the average surgical duration was(146.3±18.6)min,and the postoperative retention time of the abdominal drainage tube was(4.1±1.6)d.Removal of the abdominal drainage tube was delayed in 5 patients,and the postoperative hospital stay was(10.4±1.9)d.Nine patients had symptomatic urinary tract infection after the surgery,and one patient needed re-surgery.The above indicators showed no statistically significant differences(P>0.05).Conclusion:Compared with laparoscopic Anderson-Hynes pyeloplasty,laparoscopic renal pelvis flap ureteroplasty has no significant difference in surgical efficacy,and it is a feasible surgical method for long-segment ureteropelvic junction stricture.

关 键 词：肾盂瓣 肾盂输尿管连接处狭窄 肾积水 

分 类 号：R691.2[医药卫生—泌尿科学]