Zhang Dongzheng,Wang Xin,Wu Yong,et al.Efficacy analysis of Lich-Gregoir laparoscopy for primary vesicoureteral reflux in toddlers[J].Journal of Clinical Pediatric Surgery,2026,(01):49-54.[doi:10.3760/cma.j.cn101785-202503120]
腹腔镜Lich-Gregoir术治疗幼儿原发性膀胱输尿管反流的疗效分析
- Title:
- Efficacy analysis of Lich-Gregoir laparoscopy for primary vesicoureteral reflux in toddlers
- Keywords:
- Vesicoureteral Reflux; Urinary Bladder; Neurogenic; Laparoscope; Surgical Procedure; Operative; Child
- 摘要:
- 目的 探讨腹腔镜Lich-Gregoir术治疗幼儿原发性膀胱输尿管反流的疗效和应用价值。方法 回顾性分析2017年1月至2024年6月天津市儿童医院泌尿外科行腹腔镜Lich-Gregoir术治疗的原发性膀胱输尿管反流患儿临床资料。共67例患儿纳入研究,按照年龄和单双侧分组,分为3岁以下单侧反流组(A组,n=15),3岁以下双侧反流组(B组,n=18),3岁及以上单侧反流组(C组,n=18),3岁及以上双侧反流组(D组,n=16)。将4个亚组配为2对(A组&C组、B组&D组),比较各组性别、BMI、反流侧别、反流级别、手术情况以及术后并发症等临床资料。结果 A组、C组的手术时间分别为(92.27±15.57)min和(115.39±18.92)min,术中出血量分别为(5.27±1.83)mL和(13.56±2.36)mL;B组、D组的手术时间分别为(120.61±26.67)min和(160.19±22.86)min,术中出血量分别为(11.50±2.60)mL和(25.00±2.94)mL;差异均有统计学意义(P<0.05)。患儿性别、BMI、反流侧别、反流级别、引流管时间、导尿管时间、术后住院天数、留置双J管时间、术后急性尿潴留、留置双J管期间泌尿系感染(urinary tract infection,UTI)、拔除双J管后UTI、复发低级别反流和高级别反流差异均无统计学意义(P>0.05)。结论 腹腔镜Lich-Gregoir术治疗幼儿原发性膀胱输尿管反流安全有效,相比于年长患儿,具有手术时间更短和术中出血量更少的优势。
- Abstract:
- Objective To explore the efficacy and application value of Lich-Gregoir laparoscopy for primary vesicoureteral reflux (PVUR) in toddlers. Methods A retrospective analysis was conducted for the clinical data of 67 PVUR children undergoing Lich-Gregoir laparoscopy from January 2017 to June 2024.Based upon age and unilaterality or bilaterality,they were assigned into unilateral reflux aged under 3 years (group A,n=15),bilateral reflux aged under 3 years (group B,n=18),unilateral reflux aged 3 years and above (group C,n=18) and bilateral reflux aged 3 years and above (group D,n=16).Four subgroups were paired into two pairs (group A & group C,group B & group D).The relevant clinical data such as gender,body mass index (BMI),reflux sideness,reflux grade,intraoperative findings and postoperative complications of each group were compared. Results While comparing two groups,operative duration of groups A and C was (92.27±15.57) and (115.39±18.92) min and intraoperative blood loss (5.27±1.83) and (13.56±2.36) mL.Operative duration of groups B and D was (120.61±26.67) and (160.19±22.86) min and volume of intraoperative blood loss (11.50±2.60) and (25.00±2.94) mL respectively.The inter-group differences were statistically significant (P<0.05).No statistical significances existed in gender,BMI,reflux sideness,reflux grade,duration of drainage tube,duration of urinary catheterization,postoperative hospital stay,duration of indwelling double-J stent,postoperative acute urinary retention,urinary tract infection (UTI) during double-J stenting,UTI after removal of double-J stent,recurrence of low-grade reflux and high-grade reflux (P>0.05). Conclusions Lich-Gregoir laparoscopy is both safe and efficacious for PVUR in toddlers.As compared with elder children,it offers the advantages of shorter operative duration and less volume of intraoperative blood loss.
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备注/Memo
收稿日期:2025-3-31。
基金项目:天津市医学重点学科(专业)建设项目(TJYXZDXK—040A);天津市第二批卫生健康行业高层次人才选拔培养工程(TJSQNYXXR—D2—069)
通讯作者:关勇,Email:guanyongyisheng@163.com