Department of Pediatric Urology, Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, Beijing, People's Republic of China.
Department of Pediatric Urology, Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, Beijing, People's Republic of China.
J Pediatr Urol. 2017 Dec;13(6):618.e1-618.e5. doi: 10.1016/j.jpurol.2017.05.009. Epub 2017 Jun 3.
Laparoscopic pyeloplasty has achieved good cosmetic and functional outcomes. Both transumbilical single-site and transumbilical multi-port approaches are currently being used. No comparison of transumbilical single-site laparoscopic pyeloplasty (TSLP) and transumbilical multi-port laparoscopic pyeloplasty (TMLP) has been reported in the literature.
We present a retrospective comparison study to evaluate clinical outcomes of TSLP and TMLP for children with ureteropelvic junction obstruction (UPJO).
A retrospective study was carried out comparing TSLP and TMLP performed by a single surgeon between July 2012 and June 2014. The patient data of the two groups (90 in each group) were evaluated. All patients underwent urine analysis, ultrasonography, magnetic resonance urography, and diuretic renogram using 99Tc-diethylene triamine pentaacetic acid scan preoperative and postoperative follow-up. Data were analyzed using the SPSS 20.0 software package.
DISCUSSION: To our knowledge, our series is the first report in the literature that compares the outcomes of TSLP and TMLP in children. Our study suggested that there were no significant differences in start of oral feeding, drain removal, hospital stay, postoperative renal pelvic anteroposterior diameter and differential renal function at 6 months, postoperative complications, and success rate between the two groups. It demonstrated that TMLP is as effective and safe as TSLP. Although the cosmetic result of the TSLP group is satisfactory, TMLP requires three 0.5-cm ports around the umbilicus and does not change the shape of the umbilicus. Hence, the cosmetic result of the TMLP group is better than that of the TSLP group. TSLP involves some technical challenges. However, TMLP facilitates the procedure and renders the operation easier. Our findings confirmed that the operative time of TMLP group is shorter than that in TSLP group, and also showed that TMLP is relatively easy to perform compared with TSLP.
TMLP is a feasible and safe operation for pediatric UPJO. TMLP is shorter in operative time and has a better cosmetic result than TSLP. We propose TMLP as a more viable treatment option for pediatric UPJO.
腹腔镜肾盂成形术已取得良好的美容和功能效果。目前，经脐单部位和经脐多部位入路均有应用。文献中尚未比较经脐单部位腹腔镜肾盂成形术（TSLP）和经脐多部位腹腔镜肾盂成形术（TMLP）。
我们报告了一项回顾性比较研究，评估 TSLP 和 TMLP 治疗儿童肾盂输尿管连接部梗阻（UPJO）的临床效果。
对 2012 年 7 月至 2014 年 6 月期间由同一位外科医生进行的 TSLP 和 TMLP 进行回顾性研究。评估了两组患者（每组 90 例）的资料。所有患者术前均行尿液分析、超声检查、磁共振尿路造影和 99Tc-二乙三胺五乙酸扫描利尿肾图检查，术后进行随访。使用 SPSS 20.0 软件包进行数据分析。
讨论：据我们所知，我们的研究是文献中首次比较 TSLP 和 TMLP 在儿童中的结果。我们的研究表明，两组患者在开始口服喂养、引流管拔除、住院时间、术后 6 个月肾盂前后径和分肾功能、术后并发症和成功率方面无显著差异。结果表明 TMLP 与 TSLP 一样有效且安全。虽然 TSLP 组的美容效果令人满意，但 TMLP 需要在脐周 3 个 0.5cm 的切口，且不会改变脐的形状。因此，TMLP 组的美容效果优于 TSLP 组。TSLP 涉及一些技术挑战。然而，TMLP 有助于简化手术操作，使手术更容易进行。我们的研究结果证实 TMLP 组的手术时间短于 TSLP 组，并且与 TSLP 相比，TMLP 相对容易操作。
TMLP 是治疗小儿 UPJO 的一种可行且安全的手术方法。与 TSLP 相比，TMLP 的手术时间更短，美容效果更好。我们建议将 TMLP 作为小儿 UPJO 的更可行的治疗选择。
