Zhao Peng, Wang Cao, Mao Kaiyi, Luo Zhen, Li Yingbo, Zhou Guangxu, Tan Hongyang, Liu Hong, Mao Yucheng, Ma Hong, Shang Xianhui, Liu Bin
Guizhou Children's Hospital, Zunyi, China.
Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Front Pediatr. 2022 Aug 4;10:966292. doi: 10.3389/fped.2022.966292. eCollection 2022.
To compare the efficacy of two different surgical approaches during and after pyeloplasty according to the degree/severity of hydronephrosis factor.
Sixty child patients with UPJ obstruction admitted to our hospital from August 2019 to October 2021 were collected. Patients who underwent retroperitoneal laparoscopic pyeloplasty (RPLP) were enrolled into Group A ( = 20), while those who received transperitoneal laparoscopic pyeloplasty (TLP) were selected as Group B ( = 40). Clinical parameters, including gender, age, laterality of UPJ obstruction, degree/severity of hydronephrosis, body weight, operation time, drainage tube indwelling time, complete oral feeding time, and length of hospital stay, were compared between the two groups.
All 60 child patients were operated upon successfully without conversion to open surgery. There were no statistically significant differences in gender, age, laterality of UPJ obstruction, and body weight between the two groups, while the operation time of TLP was shorter than that of RPLP, indicating a statistically significant difference ( < 0.001). The differences in complete oral feeding time, drainage tube indwelling time, and length of hospital stay were statistically significant between the two groups, and RPLP was superior to TLP in terms of postoperative recovery time ( < 0.001). A stratified comparison showed that there were no statistically significant differences in anteroposterior diameter ≤ 20 mm, while there were statistically significant differences in anteroposterior diameter >20 mm. Hydronephrosis is reviewed after 3 months of the operation, degree/severity of hydronephrosis have been reduced.
Both RPLP and TLP are safe and feasible in the treatment of UPJ obstruction, and their overall surgical effects are equivalent. For child patients with anteroposterior diameter ≤ 20 mm, RPLP is available, while patients with anteroposterior diameter >20 mm, TLP is recommended.
根据肾盂积水程度/严重程度，比较两种不同手术方法在肾盂成形术期间及术后的疗效。
收集2019年8月至2021年10月我院收治的60例肾盂输尿管连接部梗阻患儿。接受腹膜后腹腔镜肾盂成形术（RPLP）的患者纳入A组（n = 20），而接受经腹腹腔镜肾盂成形术（TLP）的患者被选为B组（n = 40）。比较两组患者的临床参数，包括性别、年龄、肾盂输尿管连接部梗阻的侧别、肾盂积水程度/严重程度、体重、手术时间、引流管留置时间、完全经口喂养时间和住院时间。
60例患儿均手术成功，未中转开放手术。两组在性别、年龄、肾盂输尿管连接部梗阻侧别和体重方面无统计学显著差异，而TLP的手术时间短于RPLP，差异有统计学意义（P < 0.001）。两组在完全经口喂养时间、引流管留置时间和住院时间方面的差异有统计学意义，RPLP在术后恢复时间方面优于TLP（P < 0.001）。分层比较显示，前后径≤20 mm时无统计学显著差异，而前后径>20 mm时有统计学显著差异。术后3个月复查肾盂积水，肾盂积水程度/严重程度减轻。
RPLP和TLP治疗肾盂输尿管连接部梗阻均安全可行，总体手术效果相当。对于前后径≤20 mm的患儿，可采用RPLP，而对于前后径>20 mm的患儿，推荐采用TLP。
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