|
|
Effect of Laparoscopic Dismembered Pyeloplasty on Perioperative Indexes Postoperative Complications and Prognosis in Children with Hydronephrosis Caused by UPJO |
ZHOU Enhui |
Affiliated Children's Hospital of Nanjing Medical University, Jiangsu Nanjing 210000, China |
|
|
Abstract Objective: To study the effect of laparoscopic dismembered pyeloplasty (LDP) on perioperative indexes, postoperative complications and prognosis in children with hydronephrosis caused by ureteropelvic junction obstruction (UPJO). Methods: A retrospective analysis was conducted. 190 children with hydronephrosis caused by UPJO diagnosed and treated in the hospital between September 2016 and September 2019 were selected by convenience sampling. They were divided into the study group (106 cases) and the control group (84 cases) according to the operation methods. The former were treated with LDP and the latter were treated with open pyeloplasty. Observe and compare the perioperative indicators and postoperative complications of the two groups, and evaluate the renal morphology and renal function of the children after surgery. Results: The operation time of the study group was longer than that of the control group. The intraoperative blood loss, length of hospital stay and the dosage of analgesics were less or shorter than those of the control group (P<0.05). The incidence of postoperative complications was significantly lower than that of the control group (5.66% vs 14.19%, P<0.05). The thickness of renal parenchyma and glomerular filtration rates (GFR) in the two groups were increased, while the renal volume and serum creatinine (Scr) levels were decreased in 6 months after operation. Besides, the increase or decrease in study group was greater than that in the control group at 3 months after operation (P<0.05). However, there was no significant difference between the two groups at 6 months after operation (P>0.05). Conclusion: LDP is safe and effective in the treatment of children with hydronephrosis caused by UPJO. It can reduce the intraoperative blood loss and postoperative complications, promote postoperative recovery of renal morphology and renal function, and improve the prognosis.
|
|
|
|
|
[1] 曹广信,李俊峰,张广平,等.结缔组织生长因子在UPJO引发肾积水儿童患儿肾组织中的表达[J].贵州医科大学学报,2016,41(10):1224~1227. [2] 肖兴望,何大维,刘星,等.儿童单侧肾盂输尿管连接处梗阻随访结局的预测因素与观察期限分析[J].中华泌尿外科杂志,2019,40(3):215~219. [3] 王文杰,宋宏程,谢向辉,等.肾盂输尿管连接部梗阻合并同侧原发性膀胱输尿管反流诊治分析[J].临床小儿外科杂志,2019,18(10):835~838. [4] 徐疾飞,杜和喜,王建忠,等.三种不同方式的肾盂成形术治疗UPJO的疗效分析[J].安徽医科大学学报,2017,52(3):446~449. [5] 谢钧韬,高文宗,李作青,等.达芬奇机器人辅助手术治疗肾盂输尿管整形术后再狭窄[J].中华小儿外科杂志,2019(9):821~825. [6] 肖兴望,何大维.儿童肾盂输尿管连接处梗阻肾积水超声图像与非手术治疗预后相关性研究进展[J].中华实用儿科临床杂志,2019,34(11):873~876. [7] 欧元红,沈霜,葛朝勇,等.后腹腔镜下肾门后唇加肾窦内肾盂联合切开治疗肾盂鹿角形结石临床效果观察[J].实用医院临床杂志,2019,16(4):124~127. [8] 蒋健强,张卫华,李拥军,等.经皮穿刺肾盂微导丝贯通技术在复杂恶性输尿管梗阻输尿管支架置入术中的应用[J].南京医科大学学报(自然科学版),2019,39(7):1024~1027. [9] 刘树瀚,谈宜傲,乔龙标,等.小儿腹腔镜与开放离断式肾盂成形术的对比研究[J].微创泌尿外科杂志,2016,5(1):1~4. [10] 任祥斌.腹腔镜离断性肾盂成形术+肾脏折叠术治疗UPJO所致巨大肾积水的临床研究[D].山东大学,2011. [11] 翟振兴,尚攀峰,张骕,等.腹腔镜经腹腔与后腹腔途径治疗肾盂输尿管连接部梗阻的比较[J].中国微创外科杂志,2018,18(5):27~30. [12] 刘健男,刘亚东,杨可来尔,等.血清学标志物在肾积水诊断及判断预后中的意义[J].临床泌尿外科杂志,2018,33(5):393~397. [13] 顾朝辉,王一地,罗洋,等.腹腔镜肾盂成形术后再梗阻危险因素研究[J].中华实验外科杂志,2019,36(5):951~953. |
|
|
|