经脐单孔腹腔镜与传统腹腔镜肾盂输尿管切开取石术的对比研究

目的：探讨经脐单孔腹腔镜肾盂输尿管切开取石术的安全性、可行性及优势。方法：回顾性分析经脐单孔腹腔镜肾盂输尿管切开取石术（A组，n=12）及同期完成的经腰传统腹腔镜肾盂输尿管切开取石术（B组，n=16）的临床资料，对比两组手术时间、术中出血量、术后住院时间、术后引流管拔除时间、术后肠道恢复时间、总住院费用、并发症及美容效果等指标。结果：28例手术均获成功。两组术中出血量及手术时间及引流管拔除时间差异无统计学意义（P〉0．05），经脐单孔组术后住院时间及总住院费用明显优于传统腹腔镜组（P〈0．05），而传统组术后肠道恢复时间则优于经脐单孔组（P〈0．05）。结论：经脐单孔腹腔镜肾盂输尿管切开取石术是安全可行的，美容效果、术后住院时间及总住院费用明显优于传统腹腔镜。肾盂输尿管切开取石术，是一种很有前景的输尿管切开取石方法。

Comparative Study Between Transumbilical Single Port Laparoscopic and Conventional Laparoscopic Pyelolithotomy or Ureterolithotomy

Objective： To discuss the safety, feasibility and advantages of transumbilical single port laparoscopic pyelolithotomy or ureterolithotomy. Methods：The clinical documents of the patients who had been admitted into our hospital and undergone transumbilical single port laparoscopic （group A, n= 12） and conventional laparoscopic pyelolithotomy or ureterolithotomy （group B, n= 16） in the period of January 2010 to December 2010 were re- viewed. Their operation time, blood loss, hospital stay after operation, the recovery time of bowel function after operation, drainage time, cosmetic result, complications rate and the total cost were contrasted. Results：All operations were successful no post-operative complications occurred in both groups, as to blood loss, group A and B had no significant difference （P〉0.05）. As to post-operative hospital stay and the total hospital cost, group A was much superior to group B （P〈 0. 05）. However, as to the recovery time of bowel function after surgery, group B was superior to group A （P〈0.05）. Conclusions：Transumbilical single port laparoscopic pyelolithotomy or ureterolithotomy is a safe and feasible operation. It has the advantages of mini invasion, rapid recovery, short hospitalization and less total hospital cost than conventional laparoscopic pyelolithotomy or ureterolithotomy. It will demonstrate the superiority and become one of the promising surgery methods.