气膀胱腹腔镜下输尿管再植术与开放术式治疗幼儿膀胱输尿管反流的疗效比较  

Comparison of pneumovesic and open laparoscopic ureteral replantation in the treatment of vesicoureteral reflux

作　　者：朱雯雯 曹永胜[1] ZHU Wenwen;CAO Yongsheng(The Fifth Clinical Medical College of Anhui Medical University,Children s Hospital Affiliated to Anhui Medical University,Hefei 230051,China)

机构地区：[1]安徽医科大学第五临床医学院,安徽医科大学附属省儿童医院泌尿外科,安徽合肥230051

出　　处：《现代泌尿外科杂志》2023年第5期404-407,共4页Journal of Modern Urology

摘　　要：目的对比气膀胱腹腔镜下输尿管再植术与开放术式治疗原发性膀胱输尿管反流的临床疗效,总结气膀胱手术的特点。方法回顾性分析2016-2021年就诊于安徽医科大学附属省儿童医院的原发性膀胱输尿管反流患儿70例的资料,分为气膀胱组和开放组,每组35例,分别行气膀胱腹腔镜Cohen s输尿管再植术和开放Cohen s输尿管再植术。比较两组患儿手术相关资料。结果气膀胱组患儿手术切口大小(1.5 cm vs.4.0 cm)、术中出血量(2.0 mL vs.10.0 mL)均小于开放组,手术时间大于开放组[(185.3±54.2)min vs.(150.5±45.5)min];气膀胱组术后血尿时间(4.7±2.1)d、尿管留置时间(11.9±4.0)d、疼痛评分(d1:2.5±0.7,d3:1.5±0.6)、尿频尿急发生率(3%)均小于开放组[(6.0±1.3)d、(14.1±3.8)d、(d1:5.3±0.9,d3:2.9±0.6)、(17%)];气膀胱组患儿术后切口满意度(100%)大于开放组(89%);两组患儿均无术后反流复发。结论两组患儿手术疗效显著。与开放手术相比,气膀胱腹腔镜下Cohen s输尿管再植术用于治疗原发性膀胱输尿管反流,具有创伤小、外观美、恢复快、膀胱功能影响小等优点。Objective To compare the clinical efficacy of pneumovesic and open laparoscopic ureteral replantation in the treatment of primary vesicoureteral reflux,and to summarize the characteristics of pneumovesic surgery.Methods A total of 70 children with vesicoureteral reflux treated at our hospital during 2016 and 2021 were divided into pneumovesic group and open group,with 35 children in either group.The pneumovesic group underwent laparoscopic Cohen s ureteral replantation,and the open group underwent open Cohen s ureteral replantation.The operation-related data of the two groups were compared.Results Compared with the open group,the pneumovesic group had smaller incision size(1.5 cm vs.4.0 cm),less intraoperative blood loss(2.0 mL vs.10.0 mL),longer operation time[(185.3±54.2)min vs.(150.5±45.5)min],shorter postoperative hematuria time[(4.7±2.1 d)vs.(6.0±1.3 d)],shorter urinary catheter indwelling time[(11.9±4.0)d vs.(14.1±3.8)d],lower FLACC pain score[(d1:2.5±0.7,d3:1.5±0.6)vs.(d1:5.3±0.9,d3:2.9±0.6)],lower incidence of frequent and urgent urination(3%vs.17%),and higher postoperative incision satisfaction(100%vs.89%).There was no recurrence in either group.Conclusion The curative effects were significant in both groups.Compared with open surgery,pneumovesic laparoscopic ureteral replantation for the treatment of primary vesicoureteral reflux has the advantages of small trauma,beautiful appearance,quick recovery and little influence on bladder function.

关 键 词：气膀胱 腹腔镜 开放术式 输尿管再植术 输尿管反流 

分 类 号：R726.9[医药卫生—儿科]