摘要
目的通过对比研究，总结腹腔镜气膀胱Cohen输尿管移植术治疗婴幼儿巨输尿管的疗效和手术经验。方法作者于2008年1月至2012年6月采用Cohen输尿管移植术治疗年龄〈3岁的婴幼儿巨输尿管24例，其中经腹腔镜气膀胱治疗11例（双侧3例，单侧8例），为气膀胱手术组；同期开放手术治疗13例（双侧2例，单侧11例），为开放手术组。将两组患儿手术年龄、手术时间、失血量、住院时间、并发症及远期效果进行比较。结果经腹腔镜气膀胱行Cohen输尿管移植术成功10例，1例中转开腹手术（合并脊髓拴系综合征，麻醉后期出现膀胱痉挛），平均手术时间为（132．6±34．7）min，与开放手术时间[（129．7±37．2）min]相当（P〉0．05）；平均手术失血量（3．8±1．4）mL，少于开放手术组[15．4±3．7）mL]（P〈0．05）；术后平均住院时间（6．9±1．4）d，小于开放手术组[（11．3±2．6）d]（P〈0．05）。开放手术组患儿术后切口感染1例，尿外渗2例，气膀胱手术组患儿术后无明显并发症，远期随访输尿管通畅，无反流，与开放手术远期效果一致。结论年龄小于3岁的婴幼儿巨输尿管患者，经腹腔镜气膀胱行Cohen输尿管移植术是一种安全有效的治疗方式。
Objetive To summarize the therapeutic efficacy and experience of pneumovesicoscopy Co- hen ureteric reimplantation in infants. Methods During Jan. 2008 to Dec. 2012, 11 infants（ 〈3 years） with megaloureter treated with pneumovesicoscopy Cohen ureteric reimplantation. In these cases,8 cases were unilat- eral ureter and 3 cases were duplicated ureter cases, age ranged from 3 months to 37 months. The comparision between the group of cases used pneumovesicoscopy Cohen ureteric reimplantation and the group of 13 cases used open Cohen. sprocedure included age, blood loss, post -operation hospital stay, complication and thera- peutic efficacy. Results 1 case was accomplished with conversion to open surgery. The duration of operation was （ 132.6 ± 34.7 ） minutes which were coincidence to the open procedure（ P 〉 0. 05 ） ; blood loss was （ 6.8 ± 1.4） mL lower than open procedure （ P 〈 0105 ） , the postoperation hospital stay was （6.9 ± 1.4） days, low- er than open procedure. 1 patient got cut-infection and 2 patients got extravasation of urine in the group of 13 cases used open Cohen~ None of them had obstruction of ureter and vesicoureteral reflux in the 6 months - 2 year follow-up period, which were coincidence to the open procedure （P 〉 01 05）. Conclusion pneumovesi- coscopy Cohen ureteric reimplantation vialaparoseopy as a well minimally invasive surgery, which is safe and reliable in infants with megaloureter.
出处
《临床小儿外科杂志》
CAS
2013年第1期18-21,共4页
Journal of Clinical Pediatric Surgery
