腹腔镜下输尿管膀胱再植术治疗小儿膀胱输尿管反流的效果研究

作者单位:116012 辽宁 大连,大连市儿童医院泌尿外科

膀胱输尿管反流;小儿;手术治疗;腹腔镜;输尿管膀胱再植术

Clinical Effect of Laparoscopic Ureterovesical Replantation in the Treatment of Bladder-ureter Reflux in Children
LIU Dianyong

(Urology Surgery, Dalian Children’s Hospital, Dalian 116012, Liaoning Province, China)

 Vesicoureteral Reflux; Children; Operation; Laparoscopic Surgery; Laparoscopic Ureterovesical Replantation

DOI: 10.3969/j.issn.1672-7185.2019.03.027

备注

 目的  探讨腹腔镜输尿管膀胱再植术治疗小儿膀胱输尿管反流的临床效果。方法  回顾性分析2014年1月—2016年6月大连市儿童医院收治的45例膀胱输尿管反流患儿,所有患者均接受膀胱外黏膜下隧道法行腹腔镜输尿管膀胱再植术,统计患儿围手术期手术时间、术中出血量、并发症等发生情况,以及术后24个月随访预后情况。结果  所有患儿均成功完成手术,无中转开放病例;平均手术时间(120.0±31.5)min,术中平均出血量(32.1±11.5)mL,术后平均住院时间(6.5±2.2)d;共计2例患儿术后出现膀胱痉挛并发症,为一过性。24个月随访结果显示,所有患儿输尿管、肾盂扩张情况无进行性加重,无复发。结论  腹腔镜输尿管膀胱再植术治疗小儿膀胱输尿管反流,具有创伤小、并发症少等优势,具有较好的临床应用价值。
Objective To investigate the clinical effect of laparoscopic ureterovesical replantation in the treatment of bladder-ureter reflux in children. Methods  A retrospective analysis was conducted in 45 children with bladder-ureter reflux in our hospital from January 2014 to June 2016. All the patients underwent laparoscopic ureter-bladder replantation through extrabladder submucosal tunnel. The perioperative operation time, bleeding volume, complications and other indicators were analyzed, and the 24-months follow-up was performed after operation. Results  All the patients successfully completed the operation, and there were no cases of conversion to open surgery. The average operation time was (120.0±31.5) minutes. The average amount of bleeding during the operation was (32.1±11.5) mL. The average hospitalization time of the children after operation was (6.5±2.2) days. A total of 2 children had bladder spasm complications after operation, which was transient. The 24-months follow-up showed that there was no progressive aggravation of ureteropelvic dilatation and no recurrence of reflux in all children. Conclusion  Laparoscopic ureterovesical replantation has less trauma, fewer complications and high safety in the treatment of bladder-ureter reflux in children, and has good clinical application value.