摘要
目的探讨六针缝合法腹腔镜下插入式输尿管膀胱再植术的安全性及有效性。方法回顾性分析2012年3月-2015年9月16例腹腔镜下6(4+2)针缝合法插入式输尿管膀胱再植术的手术视频、临床资料。统计分析手术时间、术中出血量、术后引流量、引流管拔除时间、术后住院时间以及术后输尿管反流、狭窄等并发症发生率。结果 16例手术顺利完成,无中转开放病例。手术时间60~125 min,平均85 min。术中出血量20~50 ml,平均32 ml。术后引流量60~400 ml,平均106 ml。引流管拔除时间3~6 d,平均4.2 d。术后住院时间7~10 d,平均8.5 d。16例均获随访,随访时间6~18个月,平均12个月。无吻合口狭窄病例,1例有轻度反流,随访18个月未见加重。结论六针缝合法腹腔镜下插入式输尿管膀胱再植术安全、有效。手术时间明显缩短、没有增加吻合口狭窄及输尿管反流等并发症的发生率,有可能降低吻合口狭窄的发生率。
Objective To discuss the safety and efficacy of inserting ureterovesical reimplantation by meansof laparoscopy associated with six-stitch suture.Methods There was an retrospective analysis on operation videosand clinical data for16participants of inserting ureterovesical reimplantation by means of laparoscopy associatedwith six-stitch suture with the period from March in2012to September in2015.And these were statistically analyzedincluding the operation time,intraoperative bleeding volume,postoperative drainage volume,removal time ofdrainage tube,admission time after operation and the incidence of postoperative complications of vesicouretericreflux and stenosis.Results The operations of16participants were completed successfully without convertingto open surgery.The operation time was60~125min(Mean time:85min);intraoperative bleeding volume was20~50ml(Mean volume:32ml);postoperative drainage volume was60~400ml(Mean volume:106ml);removaltime of drainage tube was3~6d(Mean time:4.2d)and admission time after operation was7~10d(Mean time:8.5d).There was the follow-up with6~18months(Mean time:12months)for participants.No anastomotic stenosiswas present.In addition,one participant was suffered from mild vesicoureteric reflux.And there was no aggravationduring18months.Conclusions The inserting ureterovesical reimplantation by means of laparoscopy associatedwith six-stitch suture was safe and effective.It was found that the operation time was significantly shortened and the incidence of postoperative complications of vesicoureteric reflux and anastomotic stenosis was not increased.Bycontrast,the six-stitch suture could reduce the incidence of anastomotic stenosis.
作者
张楠
陈昆
郭亮
马曜辉
葛雷
郝朝辉
韩前河
胡建庭
单中杰
Nan Zhang;Kun Chen;Liang Guo;Yao-hui Ma;Lei Ge;Chao-hui Hao;Qian-he Han;Jian-ting Hu;Zhong-jie Shan(Department of Urology, Zhengzhou People's Hospital, Zhengzhou, Henan 450003, China)
出处
《中国内镜杂志》
北大核心
2017年第3期94-98,共5页
China Journal of Endoscopy
