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目的机器人辅助的腹腔镜肾盂成形术(robot-assisted laparoscopic pyeloplasty,RALPP)已用于治疗肾盂输尿管连接处梗阻(ureteropelvic junction obstruction,UPJO)。文章通过比较机器人辅助经腹腹腔镜与后腹腔镜离断式肾盂成形术治疗UPJO的效果,探讨机器人辅助经腹腹腔镜离断式肾盂成形术的临床应用价值。方法将2010年5月至2013年2月收治的12例UPJO患者作为机器人辅助经腹腹腔镜手术组(机器人组),以同期行后腹腔镜离断式肾盂成形术的13例患者为后腹腔镜手术组(后腹腔镜组),全部手术均由同一术者完成。比较手术时间、术后引流管留置时间、术后肠道排气时间、术后住院天数、肾积水减轻情况及术后并发症例数。结果 2组均成功完成手术,术中无一例中转开放手术。后腹腔镜组中2例出现术后并发症。机器人组在手术时间、术后引流管留置时间和术后院天数方面均优于后腹腔镜组,差异有统计学意义(P<0.05);而在术后肠道排气时间和术后肾积水减轻方面差异无统计学意义(P>0.05)。结论机器人辅助经腹腹腔镜下离断式肾盂成形术后并发症少,是治疗UPJO安全、有效的微创术式。
The purpose of robot-assisted laparoscopic pyeloplasty (RALPP) has been used to treat ureteropelvic junction obstruction (UPJO). By comparing the effect of robotic-assisted laparoscopic and retroperitoneal laparoscopic pyeloplasty in the treatment of UPJO, the article discusses the clinical value of robotic-assisted laparoscopic pyeloplasty. Methods Twelve patients with UPJO admitted to our hospital from May 2010 to February 2013 were enrolled as assistant robotic abdominal laparoscopic surgery group (robotic group), and 13 patients underwent laparoscopic pyeloplasty in the same period were retrobulbar Laparoscopic surgery group (retroperitoneal laparoscopic group), all operations were performed by the same surgeon. The operative time, postoperative drainage tube indwelling time, postoperative intestinal excretion time, postoperative hospital stay, hydronephrosis relief and postoperative complications were compared. Results The two groups were successfully completed the operation, no case of surgery during the open surgery. Retroperitoneal laparoscopic group 2 cases of postoperative complications. The robot group was superior to the retroperitoneal laparoscopic group in terms of operation time, postoperative drainage tube indwelling time and postoperative hospital days (P <0.05), while the time of postoperative intestinal excretion and postoperative renal There was no significant difference in hydrocephalus reduction (P> 0.05). Conclusions Robotic assisted laparoscopic transthoracic pyeloplasty has fewer complications and is a safe and effective minimally invasive surgical procedure for UPJO.