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目的分析肥胖对后腹腔镜肾切除治疗上尿路结石导致无功能肾的影响。方法443例上尿路结石导致无功能肾患者,按体质指数分为肥胖组251例,非肥胖组192例。均行后腹腔镜肾切除术。比较两组手术时间,术后平均血红蛋白下降量,住院时间,术中、术后并发症发生率。结果肥胖组手术时间为(124.25±46.52)分钟,非肥胖组为(103.25±40.76)分钟,两组比较差异有统计学意义(P<0.05);肥胖组住院时间、术后平均血红蛋白下降分别为(6.25±1.43)天和(15.75±14.28)g/L,非肥胖组分别为(5.89±1.27)天和(15.21±14.62)g/L,两组比较差异无统计学意义(P>0.05);肥胖组术中及术后早期并发症发生率分别为12.5%和6.3%,非肥胖组分别为7.6%和4.0%,两组比较差异无统计学意义(P>0.05)。结论对于上尿路结石导致的无功能肾的肥胖患者,后腹腔镜肾切除是一种安全可行的手术方式,但手术时间延长。
Objective To analyze the effect of obesity on retroperitoneal laparoscopic nephrectomy for the treatment of upper urinary tract stones leading to nonfunctional kidney. Methods 443 cases of upper urinary tract calculi leading to non-functional kidney patients, body mass index was divided into obesity group 251 cases, 192 cases of non-obesity group. All patients underwent laparoscopic nephrectomy. The operation time, the average postoperative hemoglobin decrease, hospital stay, intraoperative and postoperative complication rates were compared. Results The operation time was (124.25 ± 46.52) minutes in obesity group and (103.25 ± 40.76) minutes in non-obese group, with significant difference between the two groups (P <0.05). The hospitalization time and the average postoperative hemoglobin decrease in obese group were (5.89 ± 1.27) days and (15.21 ± 14.62) g / L respectively in the non-obese group (6.25 ± 1.43 days and 15.75 ± 14.28 g / L, respectively). There was no significant difference between the two groups (P> 0.05) The incidence of intraoperative and postoperative complications in obese patients was 12.5% and 6.3% respectively, while those in non-obese patients were 7.6% and 4.0% respectively. There was no significant difference between the two groups (P> 0.05). Conclusions Retroperitoneal laparoscopic nephrectomy is a safe and feasible surgical procedure for patients with obese renal function caused by upper urinary tract stones, but the operation time is prolonged.