Ruan Shuai,Zhou Jinhan,Li Nianwang,et al.Clinical efficacy of modified small incision retroperitoneal laparoscopy for ureteropelvic junction obstruction in children based upon computed tomography urological imaging precise positioning[J].Journal of Clinical Pediatric Surgery,,21():1153-1158.[doi:10.3760/cma.j.cn101785-202211010-010]
Clinical efficacy of modified small incision retroperitoneal laparoscopy for ureteropelvic junction obstruction in children based upon computed tomography urological imaging precise positioning
- Keywords:
- Ureteropelvic Junction Obstruction; Laparoscopes; Urologic Surgical Procedures; Postoperative Complications; Treatment Outcome
- Abstract:
- Objective To explore the clinical efficacy of modified small incision retroperitoneal laparoscopy under precise positioning of computed tomography urological imaging (CTU) for ureteropelvic junction obstruction (UPJO) in children.Methods From January 1,2016 to December 31,2021,retrospective review was conducted for clinical data of 60 children diagnosed as UPJO by imaging examination.Thirty children underwent traditional retroperitoneal laparoscopy in an early stage (control group) while another 30 children had modified small incision retroperitoneal laparoscopy under precise positioning of CTU (observation group).Two groups were compared with regards to surgical incision length,operative duration,intraoperative hemorrhage,tube indwelling time of postoperative retroperitoneal drainage and postoperative hospitalization time.And the complications of postoperative leakage,wound infection and urinary tract infection were recorded.During a follow-up period of (6-12) months,imaging examinations were performed for evaluating the recurrence rate of hydronephrosis.Results All of them recovered well and were discharged.Compared with control group,length of surgical incision was (3.28±0.60) and (3.82±0.84) cm and the differences were statistically significant (P<0.05);intraoperative hemorrhagic volume (17.50±5.83) and (22.00±14.17) ml.The difference had no statistical significance (P>0.05);operative duration (82.33±16.12) and (132.00±30.75) min and the difference was statistically significant (P<0.05);tube indwelling time of postoperative retroperitoneal drainage (4.60±2.37) and (7.33±2.37) days.The difference was statistically significant (P<0.05);postoperative hospitalization time (6.47±2.06) and (8.30±2.12) days and the difference was statistically significant (P<0.05).There were leakage (n=2) in observation group and leakage (n=4),wound infection (n=1) and urinary tract infection (n=2) in control group.The difference was not statistically significant (P>0.05).There were 1 and 2 current cases in observation and control groups and the difference was statistically significant (P>0.05).Conclusion Two different surgical approaches have a definite clinical efficacy.Modified small incision retroperitoneal laparoscopy based upon CTU precise positioning offers the advantages of shorter operative duration,faster postoperative recovery,shorter incision length and less hospitalization time.However,long-term efficacy requires further clinical trials.
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Memo
收稿日期:2022-11-5。
基金项目:湖南省卫生健康委科研课题(20200256)
通讯作者:郭玺,Email:393913230@qq.com