二次腹腔镜肾盂成形术治疗肾盂输尿管连接部梗阻疗效分析  

Efficacy of secondary laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction

作　　者：赖华健 钟文文 郭强 李俊涛 张翼飞 叶雷 马波[1] 尧冰 瞿虎[1] 邱剑光 王德娟 Lai Huajian;Zhong Wenwen;Guo Qiang;Li Juntao;Zhang Yifei;Ye Lei;Ma Bo;Yao Bing;Qu Hu;Qiu Jianguang;Wang Dejuan(Department of Urology,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院泌尿外科,广州510655

出　　处：《中华腔镜泌尿外科杂志（电子版）》2023年第3期228-232,共5页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的分析二次腹腔镜肾盂成形术(LP)的安全性和有效性。方法收集2018年1月至2022年6月我院诊治10例行二次腹腔镜肾盂成形术患儿与59例行初次腹腔镜肾盂成形术患儿的临床资料。对两组基线资料及术中、术后和随访资料进行统计,对比分析其主要临床指标。采用Clavien-Dindo标准对术后并发症进行分级。结果两组患儿在性别、年龄、体重、受累侧肾脏和临床表现方面差异均无统计学意义(P>0.05)。在术中和术后资料中,二次LP组的中位住院时间和中位术后住院时间较长(P<0.001)。二次LP组的总并发症发生率较高(P=0.006),主要为Clavien-DindoⅠ级并发症。两组的手术成功率相似(P=0.907)。结论二次腹腔镜肾盂成形术术后并发症级别低,手术成功率与初次腹腔镜肾盂成形术相仿,是针对初次腹腔镜肾盂成形术失败的一种安全有效的手术方式。Objective To analyze the safety and efficacy of secondary laparoscopic pyeloplasty.Methods From January 2018 to June 2022,the clinical data of 10 children in our hospital who underwent secondary laparoscopic pyeloplasty and 59 children who underwent primary laparoscopic pyeloplasty were collected.The baseline data,intraoperative,postoperative and follow-up data of the two groups were statistically analyzed,and the main clinical indicators were compared and analyzed.Postoperative complications were graded using the Clavien-Dindo criteria.Surgical success was defined as clinical symptom relief and no worsening of hydrops at postoperative follow-up.Results There was no significant difference in sex,age,body weight,affected kidney and clinical manifestation between the two groups(P>0.05).In the intraoperative and postoperative data,the median hospital stay for reoperation and the median postoperative hospital stay were longer in the secondary LP group(P<0.001).The total incidence of complications in the secondary LP group was higher(P=0.006),mainly Clavien-Dindo grade I complications.However,the surgical success rate was similar between the two groups(P=0.907).Conclusions The grade of complications after secondary laparoscopic pyeloplasty is low,and the surgical success rate is similar to that of primary laparoscopic pyeloplasty.It is a safe and effective surgical approach for the failure of primary laparoscopic pyeloplasty.

关 键 词：UPJ 腹腔镜 肾盂成形术 二次手术 加速康复外科 

分 类 号：R726.9[医药卫生—儿科]