论文部分内容阅读
目的:比较经脐单孔腹腔镜和传统后腹腔镜半肾切除术治疗小儿重复肾输尿管畸形的疗效。方法:将行单孔腹腔镜半肾切除术的35例患者资料与传统后腹腔镜半肾切除术20例患者资料进行配对,比较两组手术时间、术后住院时间、恢复正常饮食时间、术后并发症、围手术期超声检测结果及术后残余肾功能。结果:55例患者中位随访时间分别是12个月和24个月,术后恢复正常饮食的时间分别为(12.11±4.07)h(单孔组)和(8.93±1.31)h(传统后腹腔镜组)(P<0.05)。两组均无中转开放手术。早期的传统后腹腔镜组1例尿漏,通过7天的引流处理后自愈。单孔腹腔镜组和后腹腔镜组平均手术时间、术中出血量、术后住院时间的差异无统计学意义。两组均无并发症及死亡患者发生。两组术后均未发现下肾功能丧失,原发病的症状均改善。结论:对有经验的腹腔镜半肾切除术医生来说,经脐单孔腹腔镜半肾切除术是安全的,并取得了近似无瘢的美容结果。
Objective: To compare the efficacy of transumbilical single-hole laparoscopy and traditional retroperitoneal laparoscopic hemi-nephrectomy in the treatment of children with recurrent nephroureterectomy. Methods: The data of 35 patients who underwent single-hole laparoscopic hemi-nephrectomy were matched with the data of 20 cases of conventional retroperitoneal laparoscopic hemilertebra resection. The operation time, postoperative hospital stay, normal diet time and operation time were compared Postoperative complications, perioperative ultrasound findings and postoperative residual renal function. Results: The median follow-up time of 55 patients was 12 months and 24 months, respectively. The time to return to normal diet after operation was (12.11 ± 4.07) h (single hole group) and (8.93 ± 1.31) h Mirror group) (P <0.05). There was no transit surgery in either group. One case of urinary leakage in the early traditional laparoscopic group was self-healing after 7 days of drainage. There was no significant difference in the mean operation time, intraoperative blood loss and postoperative hospital stay between the single-hole laparoscopic group and the retroperitoneal laparoscopic group. No complications and death occurred in both groups. No loss of renal function was found in both groups, and the symptoms of the primary disease were improved. CONCLUSIONS: For experienced laparoscopic nephrectomies, transumbilical single-hole laparoscopic hemispheric nephrectomy is safe and achieves near scar-free cosmetic results.