中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
6期
417-420
,共4页
范正超%卢锦山%朱捷%王威%马鑫%许勇%胡智飞%崔亮%董金凯%高江平%张旭
範正超%盧錦山%硃捷%王威%馬鑫%許勇%鬍智飛%崔亮%董金凱%高江平%張旭
범정초%로금산%주첩%왕위%마흠%허용%호지비%최량%동금개%고강평%장욱
机器人%腹腔镜%肾盂成形术%肾盂输尿管连接部梗阻
機器人%腹腔鏡%腎盂成形術%腎盂輸尿管連接部梗阻
궤기인%복강경%신우성형술%신우수뇨관련접부경조
Robotics%Laparoscopy%Pyeloplasty%Ureteropelvic junction obstruction
目的 比较经腹腔机器人辅助与后腹腔镜下离断式肾盂成形术治疗肾盂输尿管连接处梗阻(UPJO)的手术效果.方法 2008年9月至2009年6月完成机器人辅助腹腔镜离断式肾盂成形术6例,男5例,女1例,年龄14 ～40岁,平均25岁,病变位于左右侧各3例.B超检查提示重度肾积水4例,中度肾积水2例.其中4例行IVU检查,3例显影良好.同期经后腹腔下离断式肾盂成形术12例为对照组.两组患者性别、患侧及手术方式、年龄差异均无统计学意义.比较两组手术时间、术中吻合时间、术中出血量、术后引流管、尿管留置时间、术后住院时间及手术成功率.结果 两组患者手术均获成功,无中转开放手术者.机器人组与后腹腔镜组的手术时间分别为(157±20)和(127±18)min,吻合时间(44±6)和(49± 6) min,术中出血量(23±8)和(21±17)ml,差异均无统计学意义(P＞0.05);留置引流管时间(47±10)和(161 ±41)h,导尿管留置时间(92 ±46)和(175±26)h,术后住院时间(6.0±0.8)和(8.0±0.5)d,差异均有统计学意义(P＜0.05).术后随访6～32个月,平均20个月,两组患者症状均消失,肾积水均明显减轻,未见复发.结论 经腹腔机器人辅助与后腹腔镜下离断式肾盂成形术相比,两者手术时间、术中吻合时间无明显差异,但前者留置引流管及尿管时间短,术后恢复快,临床疗效无明显差异.
目的 比較經腹腔機器人輔助與後腹腔鏡下離斷式腎盂成形術治療腎盂輸尿管連接處梗阻(UPJO)的手術效果.方法 2008年9月至2009年6月完成機器人輔助腹腔鏡離斷式腎盂成形術6例,男5例,女1例,年齡14 ～40歲,平均25歲,病變位于左右側各3例.B超檢查提示重度腎積水4例,中度腎積水2例.其中4例行IVU檢查,3例顯影良好.同期經後腹腔下離斷式腎盂成形術12例為對照組.兩組患者性彆、患側及手術方式、年齡差異均無統計學意義.比較兩組手術時間、術中吻閤時間、術中齣血量、術後引流管、尿管留置時間、術後住院時間及手術成功率.結果 兩組患者手術均穫成功,無中轉開放手術者.機器人組與後腹腔鏡組的手術時間分彆為(157±20)和(127±18)min,吻閤時間(44±6)和(49± 6) min,術中齣血量(23±8)和(21±17)ml,差異均無統計學意義(P＞0.05);留置引流管時間(47±10)和(161 ±41)h,導尿管留置時間(92 ±46)和(175±26)h,術後住院時間(6.0±0.8)和(8.0±0.5)d,差異均有統計學意義(P＜0.05).術後隨訪6～32箇月,平均20箇月,兩組患者癥狀均消失,腎積水均明顯減輕,未見複髮.結論 經腹腔機器人輔助與後腹腔鏡下離斷式腎盂成形術相比,兩者手術時間、術中吻閤時間無明顯差異,但前者留置引流管及尿管時間短,術後恢複快,臨床療效無明顯差異.
목적 비교경복강궤기인보조여후복강경하리단식신우성형술치료신우수뇨관련접처경조(UPJO)적수술효과.방법 2008년9월지2009년6월완성궤기인보조복강경리단식신우성형술6례,남5례,녀1례,년령14 ～40세,평균25세,병변위우좌우측각3례.B초검사제시중도신적수4례,중도신적수2례.기중4례행IVU검사,3례현영량호.동기경후복강하리단식신우성형술12례위대조조.량조환자성별、환측급수술방식、년령차이균무통계학의의.비교량조수술시간、술중문합시간、술중출혈량、술후인류관、뇨관류치시간、술후주원시간급수술성공솔.결과 량조환자수술균획성공,무중전개방수술자.궤기인조여후복강경조적수술시간분별위(157±20)화(127±18)min,문합시간(44±6)화(49± 6) min,술중출혈량(23±8)화(21±17)ml,차이균무통계학의의(P＞0.05);류치인류관시간(47±10)화(161 ±41)h,도뇨관류치시간(92 ±46)화(175±26)h,술후주원시간(6.0±0.8)화(8.0±0.5)d,차이균유통계학의의(P＜0.05).술후수방6～32개월,평균20개월,량조환자증상균소실,신적수균명현감경,미견복발.결론 경복강궤기인보조여후복강경하리단식신우성형술상비,량자수술시간、술중문합시간무명현차이,단전자류치인류관급뇨관시간단,술후회복쾌,림상료효무명현차이.
Objective To compare the clinical effectiveness and safety of transperitoneal robot assisted and retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction. Methods From September 2008 to June 2009,six patients with primary UPJO underwent transperitoneal robot assisted dismembered pyeloplasty (TRADP) (5 males and 1 female;average age 25 yrs,range from 14-40 yrs),of whom 4 with severe hydronephrosis,2 with intermediate.According to the demographic and preoperative information,each patient in the TRADP group was matched to two corresponding patients with primary UPJO accepting retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty (RLADP) in the same period.The operative time,the intracorporeal suturing time,intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative result were compared between the 2 groups.The two groups were identical with regard to gender,side of UPJO,and surgical procedure.The mean age and BMI were comparable between the TRADP and RLADP. Results Between the two groups,the operative time was ( 157 ± 20) min vs ( 127 ± 18) min ( P ＞ 0.05 ),the intracorporeal suturing time was (44 ± 6) min vs (49 ± 6 ) min ( P ＞0.05).In TRADP and RLADP groups,the intraoperative blood loss was (23 ± 8) ml vs (21 ± 17) ml ( P ＞ 0.05 ),the duration of the drain was (47 ± 10) h vs ( 161 ± 41 ) h ( P ＜ 0.01 ),the duration of the urethral catheter was (92 ±46) h vs ( 175 ±26) h (P ＜0.05),the postoperative hospital stays were (6.0 ± 0.8 ) d vs (8.0 ± 0.5) d ( P ＜ 0.01 ).The operation was successful in all cases of two groups,with no conversion to open surgery.The follow-up of 6 -32 months,with average of 20 months,showed that the clinical symptoms in the two groups disappeared and the hydronephrosis relieved. Conclusion Compared with RLADP,the TRADP has the comparable operative time,but the postoperative management for TRADP is more simple and the healing is faster,the postoperative outcomes are comparable as well.
