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目的观察后腹腔镜离断式肾盂成形术治疗先天性肾盂输尿管连接部梗阻(UPJO)的临床效果。方法回顾性分析深圳市坪山新区人民医院2009年1月-20 1 4年2月手术治疗的87例UPJO患者。根据手术方法不同,将患者分为观察组(后腹腔镜下离断性肾盂成形术)3 8例和对照组(Anderson-Hynes开放性离断式肾盂成形术)4 9例。观察两组手术中出血、术后并发症发生及随访24个月肾积水情况等。结果与对照组相比,观察组术中出血少,切口长度短,术后镇痛剂用量少;术后下地时间及住院时间短;术后切口感染、漏尿及腹膜后血肿发生率均低于对照组,差异有统计学意义(P<0.0 5)。两组患者术后随访24个月,肾积水发生率差异无统计学意义(P>0.0 5)。结论与传统开放式手术进行比较,后腹腔镜离断式肾盂成形术治疗UPJO创伤较小,术后并发症较少、恢复速度较快。
Objective To observe the clinical effect of retroperitoneal laparoscopic pyeloplasty in the treatment of congenital ureteropelvic junction obstruction (UPJO). Methods A retrospective analysis of 87 cases of UPJO patients underwent surgery in Pingshan New District People’s Hospital of Shenzhen from January 2009 to February 2014 was performed. According to the different surgical methods, 38 cases were divided into observation group (retroperitoneal laparoscopic pyeloplasty) and control group (Anderson-Hynes open reduction pyeloplasty) 49 cases. Bleeding in the two groups were observed, postoperative complications and hydronephrosis 24 months follow-up. Results Compared with the control group, the observation group had less intraoperative bleeding, shorter incision length, less postoperative analgesic dosage, shorter postoperative time and shorter hospital stay, and postoperative incision infection, leakage of urine and retroperitoneal hematoma Lower than the control group, the difference was statistically significant (P <0.0 5). The two groups of patients were followed up for 24 months, the incidence of hydronephrosis no significant difference (P> 0.0 5). Conclusions Compared with traditional open surgery, retroperitoneal laparoscopic pyeloplasty is less invasive and has fewer postoperative complications and faster recovery.