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目的:对比分析不同操作通道在经腹腹腔镜Anderson-Hynes术治疗婴幼儿肾盂输尿管连接处梗阻(ureteropelvic junction obstruction，UPJO)中的临床效果。方法:回顾性分析2016年6月至2019年9月于潍坊市中医院行经腹腹腔镜Anderson-Hynes术治疗的64例0~3岁UPJO患儿的临床资料，按手术通道不同，分为传统操作通道(A组，24例)、经脐缘单部位两通道(B组，21例)、经脐缘单部位三通道(C组，19例)，对比分析三种操作通道在术中出血量、手术时间、术后初次排气时间、术后疼痛评分、引流管留置时间、住院时间、切口瘢痕评分上的差异；对比术前与术后在肾盂前后径(renal pelvis anteroposterior diameter，RAPD)值、最小肾实质厚度、分肾功能(differential renal function，DRF)的变化，评估手术效果。性别及手术侧别采用Pearson n χ2检验；手术并发症分析采用Fisher\'s精确检验；三组临床治疗效果比较采用one-way ANOVA，如结果存在统计学差异则行LSD多重检验；肾积水改善情况中变量符合正态分布采用配对样本n t检验，非正态分布采用配对样本Wilcoxon符号秩检验。n 结果:64例患儿均顺利完成手术好转出院，出院后随访15.69(3~30)个月。A、B、C组的手术时间分别为(90.63±27.25)min、(100.38±29.17)min和(124.42±37.41)min，三组间比较，差异有统计学意义(n F＝6.422，n P＝0.003)；A组与B组比较，差异无统计学意义(n F＝9.318，n P＝0.299)；A组与C组比较，差异有统计学意义(n F＝9.576，n P＝0.001)；B组与C组比较，差异有统计学意义(n F＝9.874，n P＝0.018)。A、B、C组术前RAPD值分别为(3.34±0.73)cm、(3.22±0.66)cm和(3.45±0.82)cm，术后RAPD值分别为(1.95±0.45)cm、(1.83±0.38)cm和(2.08±0.62)cm，各组手术前后RAPD值比较，差异均有统计学意义(n P均<0.001)。A、B、C组最小肾皮质厚度术前分别为(2.45±0.54)mm、(2.25±0.45)mm和(2.26±0.55)mm，术后分别为(3.12±0.67)mm、(2.91±0.54)mm和(3.03±0.60)mm，各组手术前后最小肾皮质厚度值比较，差异均有统计学意义(n P均<0.001)。A组(6例)、B组(5例)和C组(9例)DRF值术前分别为31.00%(23.50%，38.00%)、33.00% (22.50%，37.00%)和31.00% (25.50%，38.50%)，术后分别为42.00%(32.50%，46.75%)、39.00% (32.50，45.00%)和40.00% (35.50%，46.00%)，各组手术前后DRF值比较，差异均有统计学意义(n P均<0.05)。n 结论:三种操作通道手术方式均安全可靠；在技术开展初期，经脐单部位三通道技术手术时间更长，难度更高，不易掌握；经脐单部位两通道操作简单，较易掌握，适合在各级医院推广。“,”Objective:To compare the clinical efficacies of different operative channels in the treatment of infants and toddlers with ureteropelvic junction obstruction (UPJO) via transperitoneal laparoscopic Anderson-Hynes.Methods:From June 2016 to September 2019, retrospective reviews were conducted for 64 infants and toddlers with UPJO undergoing transperitoneal laparoscopic Anderson-Hynes surgery at Weifang Hospital of Traditional Chinese Medicine. They were divided into three groups of traditional operative channel (A, n=24), transumbilical single-site two-port (B, n=21) and transumbilical single-site three-port (C, n=19). The differences in volume of blood loss, operative duration, postoperative initial exhaust time, postoperative pain score, indwelling time of drainage tube, incision scar score and hospitalization time of three operation channels were compared. And the changes of RAPD (renal pelvis anteroposterior diameter), pre/post-operative minimal renal parenchymal thickness and DRF (renal pelvis anteroposterior diameter) were recorded.Results:All operations were completed with an uneventful discharge. The follow-up period was 15.69(3-30) months. Operative duration: 90.63±27.25 min in group A, 100.38±29.17 min in group B and 124.42±37.41 min in group C. Statistical differences existed among three groups (n F=6.422, n P=0.003); no statistical difference between groups A and B (n F=9.318, n P=0.299); statistical difference between groups A and C (n F=9.576, n P=0.001); statistical difference between groups B and C (n F=9.874, n P=0.018). The preoperative RAPD values of groups A, B and C were (3.34±0.73), (3.22±0.66) and (3.45±0.82) cm and postoperative RAPD values (1.95±0.45), (1.83±0.38) and (2.08±0.62) cm, pre/post-operative RAPD values of each group was statistically significant (n P<0.001). The preoperative minimum renal cortical thickness were (2.45±0.54), (2.25±0.45) and (2.26±0.55) mm in groups A, B, and C and postoperative (3.12±0.67), (2.91±0.54) and (3.03±0.60) mm. The minimal renal cortex thickness values were statistically significant in each group at pre/post-operation (n P<0.001). The preoperative DRF values of groups A (n=6), B (n=5) and C (n=9) was 31.00% (23.50%, 38.00%), 33.00% (22.50%, 37.00%) and 31.00% (25.50%, 38.50%) and postoperative 42.00% (32.50%, 46.75%), 39.00% (32.50%, 45.00%) and 40.00% (35.50%, 46.00%). DRF values of each group were all statistically significant at pre/post-operation (n P<0.05).n Conclusions:All three operative channels are both safe and reliable. During an early era, transumbilical single-site three-port technology has a longer operative duration and is more difficult to master. Transumbilical single-site two-port approach is simple to operate and easier to grasp and it is suitable for a wider popularization at all levels of hospitals.