后腹腔镜与开放性手术治疗肾盂输尿管连接部梗阻的比较

目的 比较应用后腹腔镜技术与开放手术治疗肾盂输尿管连接部梗阻的效果.方法 采用后腹腔镜技术治疗肾盂输尿管连接部梗阻22例（后腹腔镜组）,开放手术21例（开放手术组）,两组分别就手术时间、出血量、术后排气时间、术后住院日等进行比较.结果 后腹腔镜组手术出血量（32.0±10.0）ml、术后排气时间（31.0±5.7）h、平均住院时间（7.0±1.6）d,均明显少于开放手术组的（70.0±11.9）ml、（52.0±6.9）h、（14.0±1.4）d;手术时间（113.0±7.6）min,长于开放手术组的（72.0±6.8）min,差异均有统计学意义（t=7.06,8.14,11.37,11.36,均P＜0.05）.结论 后腹腔镜技术治疗肾盂输尿管连接部梗阻途径直接,不会对腹腔内脏器造成干扰和污染,且损伤小、痛苦少、康复快、住院时间短.随着熟练和技术水平的提高加之相关操作器械的更新,能够缩短手术时间,可以替代开放性手术.

Comparison of the application of retroperitoneal laparoscopy and open surgery in ureteropelvic junction obstruction

Objective To review and analyze the application of retroperitoneal laparoscopy and open surgery in ureteropelvic junction obstruction, sum up clinical expeirence, and improve the skills of retropeirtoneal laparoscopic surgery. Methods Retroperitoneal laparoscopic surgery was carired out in 22 csaes of ureteropelvic junction obstruction(retroperitoneal laparoscopy group). Open surgery was carried out in 21 cases(Open surgery group). The two groups were compared in operation time, blood loss postoperative discharge time and postoperative hospital stay respectively. Results Ureteropelvic junction obstruction group was significantly less than open surgery group in intraoperative bleeding time,postoperative bleeding time and average length of stay. Operation time in ureteropelvic junction obstruction group was slightly longer than that in open surgery group (32.0 ± 10.0) ml vs (70.0 ± 11.9) ml, (31.0 ±5.7)h vs(52.0 ±6.9)h,(7.0 ± 1.6) d vs(14.0 ± 1.4) d, (113.0 ±7.6) min vs(72.0 ± 6.8) min] (t = 7.06,8. 14,11.37,11.36, all P ＜ 0.05). Conclusions Retroperitoneal laparoscopic technology was in the treatment of ureteropelvic junction obstruction for its direct way, had non interference and pollution to laparoscopic internal organs,less damage,less pain, rapid recovery and short hospitla stay. With on going training and constantly updating technical skills and equipments, retroperitoneal laparoscopic technology will shotren the operation time, and will substitute open surgery.