小儿肾发育不良手术方法探讨

目的评价后腹腔镜、腹腔镜以及开腹手术3种方法治疗发育不良肾的临床利弊。方法2005年12月至2010年12月，作者共收治31例发育不良肾患儿，采用后腹腔镜、腹腔镜以及开腹手术3种方式治疗，比较3种术式在手术时间、出血量、术后住院时间以及并发症的发生率方面的差别。结果3组手术均获成功，经后腹腔镜组手术时间平均为（149±14）min，腹腔镜组手术时间平均为（145±13）min，开放手术组手术时间平均为（103±10）min。术中出血量分别为（14．7±1．1）mL、（16．2±1．6）mL、（21．1±1．4）mL。术后住院时间分别为（6±0．8）d、（6±0．9）d、（10±1．2）d。3组术后均无并发症。结论小儿肾发育不良在腹腔镜和后腹腔镜下手术，其术后恢复时间、术中出血量比较，均明显优于开腹手术，但手术时间较开腹手术长。

Evolution of the technique in the nephrectomy for renal dysgenesis in children

Objective The aim of this study is to exam the outcome of Posterior laparoscopy （ PL）, laparoscopy（L） ,versus Open （O） nephrectomy for renal dysgenesis in children. Methods Records of 31 pa- tients who underwent a nephrectomy for renal dysgenesis were reviewed from Dec. 2005 to Dec. 2010. we com- pared 31 cases the outcome of three different technique in the nephrectomy for renal dysgenesis, which include operating time, average hospital stay, bleeding volume and complication after surgery. Results No complica- tion happened in this study. The operating time was shorter （ 149 ＋ 14 vs 145 ＋ 13 vs 103 ＋ 10minutes, P 〈 0. O1 ） in the open nephrectomy. Outcomes were improved in the PL and L groups, as evidenced by bleeding volume （ 14.7 ＋ 1.1 vs 16.2 _＋ 1.6 vs 21.1 ＋ 1.4 ml,P 〈 0.01 ） and decreased hospital stay （6 ＋ 0.8 vs 6 -＋ 0.9 vs 10 _＋ 1.2 days, P 〈 0.01 ）. This had no significant different on the complication. Conclusions Our study showed significanting better results regarding stay hospital and bleeding volume for the PL and L with open group. The operating time was somewhat better for the open group. The three methods have their advantages and disadvantages.