六针缝合法在腹腔镜下插入式输尿管膀胱再植术中的应用

发布时间：2019-03-19 08:24

【摘要】：目的探讨六针缝合法腹腔镜下插入式输尿管膀胱再植术的安全性及有效性。方法回顾性分析2012年3月-2015年9月16例腹腔镜下6(4+2)针缝合法插入式输尿管膀胱再植术的手术视频、临床资料。统计分析手术时间、术中出血量、术后引流量、引流管拔除时间、术后住院时间以及术后输尿管反流、狭窄等并发症发生率。结果 16例手术顺利完成,无中转开放病例。手术时间60~125 min,平均85 min。术中出血量20~50 ml,平均32 ml。术后引流量60~400 ml,平均106 ml。引流管拔除时间3~6 d,平均4.2 d。术后住院时间7~10 d,平均8.5 d。16例均获随访,随访时间6~18个月,平均12个月。无吻合口狭窄病例,1例有轻度反流,随访18个月未见加重。结论六针缝合法腹腔镜下插入式输尿管膀胱再植术安全、有效。手术时间明显缩短、没有增加吻合口狭窄及输尿管反流等并发症的发生率,有可能降低吻合口狭窄的发生率。
[Abstract]:Objective to evaluate the safety and efficacy of laparoscopic ureterocystectomy with six-needle suture. Methods from March 2012 to September 2015, the clinical data of 16 cases of laparoscopic 6 (42) suture implantation of ureter and bladder were retrospectively analyzed. The incidence of complications such as operative time, intraoperative bleeding, postoperative drainage volume, drainage tube extraction time, postoperative hospital stay, postoperative ureteral reflux and stricture were analyzed. Results the operation was successfully completed in 16 cases, and no cases of conversion to open operation were found. Operation time 60 to 125 min, average 85 min. Intraoperative bleeding volume 20-50 ml, average 32 ml. Postoperative drainage volume 60 to 400 ml, average 106 ml. The drainage tube was removed for 3 days and 6 days, with an average of 4.2 d. All patients were followed up for 7 days and 10 days, with an average of 8.5 d. 16 patients were followed up for 6 months and 18 months (mean 12 months). No anastomotic stricture was found in 1 case with mild reflux, and no aggravation was found in 18 months follow-up. Conclusion six-needle suture laparoscopic ureterocystectomy is safe and effective. The operative time was shortened and the incidence of anastomotic stricture and ureteral reflux was not increased, which might reduce the incidence of anastomotic stricture.
【作者单位】：河南省郑州人民医院泌尿外科;
【分类号】：R699

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