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输尿管狭窄的治疗:机器人辅助腹腔镜输尿管输尿管吻合术与传统腹腔镜输尿管输尿管吻合术的比较

Management for Ureteral Stenosis: A Comparison of Robot-Assisted Laparoscopic Ureteroureterostomy and Conventional Laparoscopic Ureteroureterostomy.

作者信息

Sun Guoliang, Yan Libin, Ouyang Wei, Zhang Yucong, Ding Beichen, Liu Zheng, Yu Xiao, Hu Zhiquan, Li Heng, Wang Shaogang, Ye Zhangqun

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2019 Sep;29(9):1111-1115. doi: 10.1089/lap.2019.0357. Epub 2019 Jul 17.

Abstract

To describe and analyze our experience of robotic-assisted laparoscopic ureteroureterostomy (RALU) and conventional LU for the repair of ureteral stenosis and compare the differences of safety and efficacy between RALU and LU. Patients who underwent RALU or LU for ureteral stenosis were retrospectively analyzed. Baseline characteristics, details of stenosis, surgery and some laboratory tests, and follow-up data were collected and analyzed. Among 126 patients presented with ureteral stenosis, 65 patients underwent RALU and 61 patients underwent LU. All operations were completed successfully without conversion to open surgery. Both groups were comparable in baseline characteristics and details of stenosis. The mean operative time, suturing time, and hospitalization time of patients in RALU group were significantly less than those in LU group. The mean operative time of the RALU group was 126.34 minutes, whereas the mean operative time of the LU group was 176.57 minutes ( < .001). The average suturing time of RALU and LU was 26.88 and 70.43 minutes, respectively ( < .001). The mean hospitalization time of RALU and LU was 4.01 and 5.02, respectively ( < .001). RALU presented a lower degree of leukocytes rise than LU ( < .001). The mean follow-up time was 29.52 months. RALU and LU both are safe and feasible for ureteral stenosis with a low incidence of complications. Compared with LU, RALU may be a better choice with shorter operative time, suturing time, postoperative hospitalization time, and slighter inflammation. Further clinical studies of high quality are needed to confirm the priority of RALU.

摘要

描述并分析我们采用机器人辅助腹腔镜输尿管输尿管吻合术(RALU)和传统腹腔镜输尿管吻合术(LU)修复输尿管狭窄的经验,并比较RALU和LU在安全性和有效性方面的差异。对因输尿管狭窄接受RALU或LU手术的患者进行回顾性分析。收集并分析患者的基线特征、狭窄细节、手术情况及一些实验室检查结果以及随访数据。在126例输尿管狭窄患者中,65例行RALU,61例行LU。所有手术均成功完成,未中转开放手术。两组在基线特征和狭窄细节方面具有可比性。RALU组患者的平均手术时间、缝合时间和住院时间均显著短于LU组。RALU组的平均手术时间为126.34分钟,而LU组为176.57分钟(<0.001)。RALU和LU的平均缝合时间分别为26.88分钟和70.43分钟(<0.001)。RALU和LU的平均住院时间分别为4.01天和5.02天(<0.001)。RALU患者白细胞升高程度低于LU(<0.001)。平均随访时间为29.52个月。RALU和LU对于输尿管狭窄均安全可行,并发症发生率低。与LU相比,RALU手术时间、缝合时间、术后住院时间更短,炎症反应更轻,可能是更好的选择。需要进一步高质量的临床研究来证实RALU的优势。

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