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1岁以下儿童标准腹腔镜肾盂成形术与迷你腹腔镜肾盂成形术的手术结果及美容效果比较。

Comparison of surgical outcomes and cosmetic results between standard and mini laparoscopic pyeloplasty in children younger than 1 year of age.

作者信息

Simforoosh N, Abedi A, Hosseini Sharifi S H, Poor Zamany N K M, Rezaeetalab G H, Obayd K, Soltani M H

机构信息

Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No. 99, 9th Boostan, Pasdaran Avenue, Tehran, Iran.

Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, No. 99, 9th Boostan, Pasdaran Avenue, Tehran, Iran.

出版信息

J Pediatr Urol. 2014 Oct;10(5):819-23. doi: 10.1016/j.jpurol.2014.01.026. Epub 2014 Feb 22.

Abstract

OBJECTIVE

To evaluate safety, efficacy, and cosmetic results after mini laparoscopic (mL) pyeloplasty and standard (sL) pyeloplasty in children younger than 1 year of age with ureteropelvic junction obstruction (UPJO).

MATERIALS AND METHODS

From August 2009 to March 2011, 20 sL pyeloplasties were performed in pediatric patients younger than 1 year of age; afterwards, 20 patients younger than 1 year of age underwent mini laparoscopic (mL) pyeloplasty from June 2011 to August 2012. The patients were followed by urine culture and ultrasonography at 3 and 6 months after surgery. Cosmetic appearance was assessed in all patients in both groups group 3 months after surgery using the Patient Scar Assessment Questionnaire.

RESULTS

Peri and postoperative results revealed that operative time (total and anastomosis of ureteropelvic junction), hospital stay, and overall complication rate were significantly lower in mL than in sL. Persistent hydronephrosis in follow-up imaging and recurrence of obstruction was not observed in any cases. Mean appearance score and consciousness score showed significantly better results in the mL group.

CONCLUSION

We believe that mL pyeloplasty in infant cases with UPJO is more cosmetically pleasing and less invasive than sL pyeloplasty and has similar functional outcomes.

摘要

目的

评估小于1岁的输尿管肾盂连接部梗阻(UPJO)患儿行迷你腹腔镜肾盂成形术(mL)和标准腹腔镜肾盂成形术(sL)后的安全性、有效性及美容效果。

材料与方法

2009年8月至2011年3月,对小于1岁的儿科患者实施了20例标准腹腔镜肾盂成形术;之后,2011年6月至2012年8月,对20例小于1岁的患者实施了迷你腹腔镜肾盂成形术。术后3个月和6个月对患者进行尿培养和超声检查随访。术后3个月使用患者瘢痕评估问卷对两组所有患者的美容外观进行评估。

结果

围手术期及术后结果显示,迷你腹腔镜肾盂成形术组的手术时间(输尿管肾盂连接部总的及吻合的时间)、住院时间及总体并发症发生率均显著低于标准腹腔镜肾盂成形术组。随访影像学检查未发现持续性肾积水及梗阻复发的病例。迷你腹腔镜肾盂成形术组的平均外观评分和满意度评分结果显著更好。

结论

我们认为,对于患有输尿管肾盂连接部梗阻的婴儿病例,迷你腹腔镜肾盂成形术比标准腹腔镜肾盂成形术在美容方面更令人满意,侵入性更小,且功能效果相似。

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