机器人辅助腹腔镜在输尿管肠吻合口狭窄治疗中的优势:与内镜球囊扩张的比较分析  

Advantages of robot-assisted laparoscopy in the treatment of ureteroenteric anastomotic stricture:a comparative analysis with endoscopic balloon dilation

作　　者：许晓波[1] 吕佳[1] 毛祖杰[1] 刘锋[1] 王帅[1] 祁小龙[1] XU Xiaobo;LYU Jia;MAO Zujie;LIU Feng;WANG Shuai;QI Xiaolong(Department of Urology,Zhejiang Provincial People's Hospital,Affiliated People's Hospital,Hangzhou Medical College,Hangzhou,310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)泌尿外科,杭州310014

出　　处：《临床泌尿外科杂志》2024年第6期531-533,538,共4页Journal of Clinical Urology

摘　　要：目的:比较机器人辅助腹腔镜输尿管膀胱再植术(robot-assisted laparoscopic ureteral reimplantation,RAUR)与内镜球囊扩张治疗根治性膀胱切除术后输尿管肠吻合口狭窄(ureteroenteric stricture,UES)的疗效。方法:回顾性分析2015年1月—2022年12月在浙江省人民医院行RAUR或内镜球囊扩张治疗UES的患者临床资料,共纳入RAUR组28例,球囊组16例;另有9例患者球囊扩张治疗失败,Ⅱ期行RAUR,单独成组为球囊后RAUR组。比较3组患者的手术时间、出血量、并发症发生率等围手术期指标及治疗成功率等。结果:3组患者的性别、年龄、狭窄长度、术前肾功能等一般资料比较差异无统计学意义(P>0.05),具有可比性。RAUR组和球囊后RAUR组较球囊组手术时间延长(均P<0.001),出血量增多(P<0.001,P=0.020)。RAUR组、球囊后RAUR组和球囊组的治疗成功率分别为92.86%、88.89%和62.50%,差异有统计学意义(P=0.031)。合并RAUR组的总成功率为91.89%,明显高于球囊组的62.50%(P=0.027)。3组术后Ⅱ级并发症发生率分别为10.71%、11.11%和6.25%,差异无统计学意义(P=0.872)。未发生Ⅲ级及以上并发症。结论:对于根治性膀胱切除术后UES,RAUR疗效确切,并发症可控。Objective To compare the efficacy between robot-assisted laparoscopic ureteral reimplantation(RAUR)and endoscopic balloon dilation in treating benign ureteroenteric stricture(UES)after radical cystectomy.Methods A retrospective analysis was conducted on the clinical data of patients who underwent RAUR(28 cases)or balloon dilation(16 cases)for UES in Zhejiang Provincial People's Hospital from January 2015 to December 2022.Additionally,9 patients underwent RAUR after failed balloon dilation.Perioperative indicators such as operation time,blood loss,complication rates,and treatment success rates were compared among the three groups.Results The baseline characteristics were comparable among the three groups(P>0.05).The operation time of the RAUR group and the balloon-then-RAUR group was longer than that of the balloon group(both P<0.001),and blood loss was slightly higher(P<0.001,P=0.020).The treatment success rates of the RAUR group,balloon-then-RAUR group,and balloon group were 92.86%,88.89%,and 62.50%,respectively,with a statistically significant difference(P=0.031).The overall success rate of the combined two RAUR groups was 91.89%,significantly higher than that of the balloon group at 62.50%(P=0.027).The incidences of postoperative gradeⅡcomplications were 10.71%,11.11%,and 6.25%respectively,with no statistically significant difference(P=0.872).No gradeⅢor higher complications occurred.Conclusion For UES after radical cystectomy for bladder cancer,RAUR has a definite efficacy and controllable complications.

关 键 词：机器人手术 腹腔镜 输尿管肠吻合口狭窄 内镜治疗 球囊扩张 根治性膀胱切除术 

分 类 号：R737.14[医药卫生—肿瘤]