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目的:比较机器人辅助腹腔镜和普通腹腔镜肾盂成形术治疗肾盂输尿管连接部(UPJ)狭窄所致肾积水的临床资料,探讨UPJ成型的最佳治疗方案。方法:2012年3月~2012年7月,收治7例UPJ狭窄患者,采用经腹腔途径施行机器人辅助腹腔镜肾盂成形术治疗UPJ狭窄2例;采用经腹腔途径腹腔镜肾盂成形术治疗UPJ狭窄5例。所有手术均由具有熟练腹腔镜UPJ成型手术经验的同一术者完成。结果:7例手术均获成功。其中机器人辅助腹腔镜UPJ成型手术时间90~140 min(剔除平均56min的机器人准备和摆体位的时间),平均115min,出血量30~70ml,术后住院时间都为7d,术后随访2~3个月,超声提示集合系统分离分别减少至1.5、2.0cm,腰痛症状均消失。5例行普通腹腔镜UPJ成型患者手术时间90~180min,平均120min,出血量100~200ml,术后平均住院8d,术后随访2~12个月,超声提示集合系统分离减少至平均2.3cm。结论:机器人辅助腹腔镜UPJ狭窄离断成型术在手术吻合时间和术中出血方面与普通腹腔镜相比具有一定优势,术中缝合步骤得到显著简化,手术效率提高,且缝合效果更为满意,操作更加精确。
Objective: To compare the clinical data of robot-assisted laparoscopy and general laparoscopic pyeloplasty in the treatment of hydronephrosis caused by ureteropelvic junction (UPJ) stenosis, and to explore the best treatment for UPJ. Methods: From March 2012 to July 2012, 7 patients with UPJ stenosis were treated with robotic-assisted laparoscopic pyeloplasty in 2 patients with UPJ stenosis. Laparoscopic pyeloplasty was used to treat 5 patients with UPJ stenosis 5 example. All surgeries are performed by the same surgeon who has experienced laparoscopic UPJ surgery. Results: All the 7 surgeries were successful. The robot assisted laparoscopic UPJ molding operation time 90 ~ 140 min (excluding an average of 56min robotic preparations and pendulum position time), an average of 115min, the amount of bleeding 30 ~ 70ml, postoperative hospital stay was 7d, followed up 2 ~ 3 Month, ultrasound prompted the collection system separation were reduced to 1.5,2.0cm, low back pain symptoms disappeared. Five patients underwent routine laparoscopic UPJ surgery. The operation time ranged from 90 to 180 minutes, with an average of 120 minutes. The mean amount of bleeding was 100 to 200ml. The average duration of postoperative hospital stay was 8 days. The follow-up period was 2 to 12 months. Ultrasound suggested that the collection system was reduced to an average of 2.3cm. Conclusion: The robot-assisted laparoscopic UPJ stenosis and disconnection has some advantages over conventional laparoscopy in operative anastomosis and intraoperative hemorrhage. The suture procedure is significantly simplified, the operative efficiency is improved, and the suture effect is more satisfactory. More precise operation.