两种手术治疗肾盂输尿管交界部梗阻的临床疗效及安全性比较

摘要

Objective To evaluate the clinical efficiency and safety between retroperitoneal laparoscopic and open dismembered pyeloplasty in the treatment of ureteropelvic junction obstruction(UPJO).Methods A total of 76 patients with UPJO in our department from June 2003 to September 2013 were selected.Among them,33 cases un-derwent retroperitoneal laparoscopic dismembered pyeloplasty and 43 cases underwent open dismembered pyeloplas-ty.The operation time,intraoperative blood loss volume,operation success rate and incidence of complications were retrospectively analyzed and compared between the 2 groups.Results The operation time was significantly longer in the laparoscopic surgery group than the open surgery group (P <0.05).In the laparoscopic group,the intraoperative blood loss volume and postoperative hospital stay were significantly better than those in the open surgery group,the differences were statistically significant (P <0.05),but the operation success rate and incidence rate of postoperative complications had no statistical differences between the two groups(P >0.05 ).During the 6 -27 months follow up period,B-ulrasonography showed that hydronephrosis in all cases was disappeared or significantly decreased.Conclu-sion Retroperitoneal laparoscopic dismembered pyeloplasty is safe and effective,and has the advantages of small trauma,less blood loss,fewer complications and rapid recovery,which can gradually replace the conventional open surgery in clinical application.%目的：比较后腹腔镜与开放离断式肾盂成形术治疗肾盂输尿管交界部梗阻的有效性及安全性。方法选择该科2003年6月至2013年9月收治肾盂输尿管交界部梗阻患者76例,对其中33例行后腹腔镜下离断式肾盂成形术,43例行开放离断式肾盂成形术,对比分析两组患者手术时间、术中出血量、术后住院时间、手术成功率及并发症发生率等。结果后腹腔镜组手术时间明显长与开放手术组(P <0.05),而在术中出血量、术后住院时间均优于开放手术组,差异有统计学意义(P <0.05)。两组手术成功率及并发症发生率比较,差异无统计学意义(P >0.05)。术后随访6~27个月,B 超提示所有患者肾积水均明显减轻或消失。结论后腹腔镜离断式肾盂成形术安全有效,并具有创伤小、出血少、并发症少、恢复快等优点,可逐渐取代开放式手术。