后腹腔镜与开放离断肾盂成形术的临床效果比较

目的：通过与开放离断肾盂成形术的效果比较，评价后腹腔镜离断肾盂成形术的临床价值。方法：回顾性分析的腹腔镜离断肾盂成形术56例（A组）及开放离断肾盂成形术10例（B组）的临床资料，就两组手术时间、术中出血量、术后肠道功能恢复时间、术后止疼药用量、术后住院天数，并发症和成功率等指标进行比较。根据数据类型选用X^2检验，成组t检验或Mann-Whitey U检验。结果：A组在术中出血量，术后肠道功能恢复时间，术后止产药用量。术后住院天数方面优于B组，差异有统计学意义（P〈0.01）；并发症和成功率与B组相当，差异无统计学意义（P〉0.05）。结论：后腹腔镜离断肾盂成形术是一种治疗肾盂输尿管连接部梗阻的微阳、安全、有效的方法，但存在较明显的学习期。熟练后可在较短时间内完成手术。

A comparison of the clinical outcome between retroperitoneal laparoscopic and open dismembered pyeloplasty

Objective:To assess the clinical value of retroperitoneal laparoscopic dismembered pyeloplasty as compared and open pyeloplasty.Methods:The clinical data (demographic, intraoperative, postoperative and mid-term follow-up data) for 56 patients who underwent retroperitoneal laparoscopic dismembered pyeloplasty were retrospectively compared with those for 40 patients who underwent open dismembered pyeloplasty through a retroperitoneal flank approach. Student-test, Pearson chi-square test and Mann-Whitney rank sum test were applied for statistical analysis as appropriate. Statistical significance was defined as P<(0.05).Results:Patient demographics were similar between the two groups. In group A, operation time, estimated blood loss, recovery of intestinal function, analgesic requirements, postoperative length of hospital stay are better than those in group B (P<(0.01)). No intraoperative complications occurred in either group. Incidence of postoperative complications and success rate are equivalent in group A and B (P>(0.05)).Conclusions:In experienced hands, retroperitoneal laparoscopic dismembered pyeloplasty is a minimally invasive, safe and effective therapy for UPJ obstruction with low morbidity, shorter convalescence and excellent outcomes and can be accomplished reasonably quickly.