腹腔镜与开放肾盂成形术治疗小儿肾盂输尿管连接处梗阻的Meta分析  

Laparoscopic versus open pyeloplasty in the treatment of ureteropelvic junction obstruction in children: a Meta-analysis

作　　者：李贤辉 杨平[1] 李康明 刘明 Li Xianhui;Yang Ping;Li Kangming;Liu Ming(Department of Urology,Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院泌尿外科,遂宁629000

出　　处：《国际泌尿系统杂志》2025年第1期81-86,共6页International Journal of Urology and Nephrology

基　　金：四川省医学科研项目(S20067)。

摘　　要：目的运用Meta分析评价腹腔镜肾盂成形术(LP)与开放肾盂成形术(OP)治疗小儿肾盂输尿管连接处梗阻的临床效果。方法检索Pubmed、Embase、Web of Science、Cochrane Library、中国知网、维普、万方等数据库中关于LP与OP治疗小儿肾盂输尿管连接处梗阻的文献研究,检索时限为2000年1月至2022年10月,经过严格的纳入、排除标准并进行质量评价,采用RevMan 5.3软件进行Meta分析,对LP(LP组)与OP(OP组)治疗小儿肾盂输尿管连接处梗阻的临床效果进行比较。结果共纳入15篇文献,包括6173例患儿,Meta分析结果显示,相较于OP组,LP组的手术时间更长(MD=48.31,95%CI:29.02~67.59,P<0.001),住院时间更短(MD=-2.58,95%CI:-4.59~-0.58,P=0.009),术中失血量更少(MD=-7.40,95%CI:-11.23~-3.57,P<0.001),而两组的术后并发症、手术成功率、吻合口瘘发生率、再次手术率比较,差异均无统计学意义(均P>0.05)。结论LP在一定意义上可替代OP,其住院时间更短,术中失血量更少,是治疗小儿肾盂输尿管连接处梗阻的有效方式。Objective To systematically review the efficacy of laparoscopic pyeloplasty(LP)versus open pyeloplasty(OP)for children with ureteropelvic junction obstruction(UPJO)through Meta-analysis.Methods We systematically searched the comparative studies in Pubmed,Embase,Web of Science,Cochrane Library,CNKI,Vip,Wanfang and other databases from January 2000 to October 2022.After applying rigorous inclusion and exclusion criteria,conducting a thorough quality evaluation,and employing RevMan 5.3 software for Meta-analysis,we compared the clinical efficacy of LP(LP group)versus OP(OP group)in the management of ureteropelvic junction obstruction in pediatric patients.Results A total of 15 literatures were included,including 6173 children.The results of Meta-analysis showed that compared with OP group,LP group had a longer operation time(MD=48.31,95%CI:29.02-67.59,P<0.001)and a shorter hospital stay(MD=-2.58,95%CI:-4.59--0.58,P=0.009),and less intraoperative blood loss(MD=-7.40,95%CI:-11.23--3.57,P<0.001),while there were no statistically significant differences in postoperative complications,surgical success rate,incidence of anastomotic fistula,and reoperation rate between the two groups(all P>0.05).Conclusions LP can replace OP in a certain sense,with shorter hospital stay and less intraoperative blood loss,which is an effective way to treat ureteropelvic junction obstruction in children.

关 键 词：肾盂输尿管连接处梗阻 儿童 腹腔镜检查 肾盂成形术 

分 类 号：R726.9[医药卫生—儿科]