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目的:比较后腹腔镜输尿管切开取石术中“连续缝合技术”和“间断缝合技术”的临床应用。方法:回顾性分析2012年5月~2016年4月在我院行后腹腔镜输尿管切开取石术的112例输尿管结石患者的临床资料。根据术中输尿管吻合方法不同,分为连续缝合组52例(A组)和间断缝合组60例(B组)。比较两组患者的结石大小、体重指数、总手术时间、输尿管缝合时间、缝合针数、术中出血量、术后住院时间、引流管拔出时间及漏尿及输尿管狭窄等并发症发生率。结果:112例手术均获成功。两组患者结石大小及体重指数等一般资料比较差异无统计学意义。A组平均手术时间为53.5min,明显低于B组的手术时间65.7min(P<0.05),其中输尿管缝合时间为10.5min,低于B组的输尿管缝合时间18.9min(P<0.05)。两组患者缝合针数、术中出血量、术后住院时间、引流管拔出时间等比较差异无统计学意义。A组围手术期无漏尿病例,B组围手术期漏尿2例。随访3~9个月,两组患者肾输尿管积水明显改善,均未发现输尿管狭窄等并发症。结论:后腹腔镜输尿管切开取石术中应用连续缝合技术可降低输尿管缝合难度、缩短手术时间、减少术后尿漏发生率。
Objective: To compare the clinical application of retroperitoneal laparoscopic ureterolithotomy with continuous suture technique and intermittent suture technique. Methods: The clinical data of 112 patients with ureteral calculi underwent laparoscopic ureterolithotomy in our hospital from May 2012 to April 2016 were retrospectively analyzed. According to intraoperative ureteral anastomosis different methods, divided into continuous suture group 52 cases (group A) and intermittent suture group 60 cases (group B). The incidence of complications such as stone size, body mass index, total operation time, ureteral suture time, number of suture needle, intraoperative blood loss, postoperative hospital stay, drainage time and leakage of urine and ureteral stricture were compared between the two groups. Results: All the 112 surgeries were successful. The two groups of patients with stone size and body mass index and other general information was no significant difference. The average operation time in group A was 53.5min, which was significantly lower than that in group B (65.7min, P <0.05). The ureter suture time was 10.5min and the ureteral suture time was 18.9min in group B (P <0.05). There was no significant difference in the number of suture needles, intraoperative blood loss, postoperative hospital stay and drainage time between the two groups. A group of perioperative cases without leakage, B group perioperative leakage of urine in 2 cases. All the patients were followed up for 3 to 9 months. Renal ureter hydronephrosis was significantly improved in both groups. No complications such as ureteral stricture were found. Conclusion: The retroperitoneal laparoscopic ureterolithotomy using continuous suture technique can reduce the ureteral suture difficulty, shorten the operation time and reduce the incidence of postoperative urinary leakage.