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目的:探讨使用迷你腹腔镜经后腹腔肾盂成形术治疗肾盂输尿管连接部狭窄(UPJO)的安全性和临床治疗效果。方法:2011年9月~2014年9月应用迷你腹腔镜术治疗UPJO患者29例(MLP组),同期应用目前标准腹腔镜手术治疗该病患者22例(SLP组),并对两组的临床治疗结果作对比分析。结果:两组患者的肾盂输尿管成形术均成功完成,均无中转开放手术患者。两组在手术时间、手术出血量、留置引流管时间、术后恢复饮食时间、尿瘘及伤口感染发生率等方面差异无统计学意义(P>0.05)。MLP组患者平均住院时间、术后额外止痛药需求量、术后当天疼痛评分均小于SLP组(P<0.05)。术后随访平均时间23(6~36)个月。术后1年时,平均肾集合系统扩张分离的前后径值与术前相比,两组均明显减少,但两组间差异无统计学意义(P>0.05);利尿肾图显示患侧肾平均GFR两组差异无统计学意义[MLP组(45±18)ml/min vs SLP组(47±16)ml/min,P>0.05],但与术前相比,两组GFR值均明显增加。患者形体恢复满意度调查,MLP组的“很满意”明显大于SLP组(P<0.05)。结论:迷你腹腔镜进行肾盂成形术治疗UPJO安全可靠,能取得和传统腹腔镜术同样的临床治疗效果,但手术创伤更小,术后形体恢复更满意。
Objective: To investigate the safety and clinical efficacy of mini laparoscopic retrobulbar pyeloplasty in the treatment of ureteropelvic junction stenosis (UPJO). Methods: From September 2011 to September 2014, 29 patients with UPJO (MLP group) underwent mini laparoscopic surgery and 22 patients (SLP group) undergoing standard laparoscopic surgery at the same period. The clinical data of two groups Treatment results for comparative analysis. Results: The ureteropelvic angioplasty was completed successfully in both groups. There were no patients undergoing open surgery. There was no significant difference between the two groups in operation time, blood loss of operation, indwelling drainage tube time, postoperative recovery diet time, urinary fistula and wound infection rate (P> 0.05). The average duration of hospital stay, postoperative additional pain medication requirements, postoperative pain scores in MLP group were less than those in SLP group (P <0.05). The average follow-up time was 23 (6 ~ 36) months. At 1 year after operation, mean diameter of anastomosed renal collection system was significantly lower than that before operation in both groups, but there was no significant difference between the two groups (P> 0.05) There was no significant difference between the two groups in mean GFR [MLP (45 ± 18) ml / min vs. SLP (47 ± 16) ml / min, P> 0.05] increase. Patient satisfaction survey of body shape, MLP group “very satisfied ” was significantly greater than the SLP group (P <0.05). Conclusion: Laparoscopic pyeloplasty for the treatment of UPJO is safe and reliable, and can achieve the same clinical effect as traditional laparoscopic surgery. However, the surgical trauma is smaller and the postoperative recovery of body shape is more satisfactory.