在儿科的骨盆-尿道结合阻塞中, laparoscopic 与开放型皮叶造形相比
Mohammad A Tanash1,2, Bapesh K Bollu1, Rasika Naidoo1
1Paediatric Urology Unit, Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Journal of paediatrics and child health
|May 29, 2023
概括
laparoscopic pyeloplasty (LP) 和开放式 pyeloplasty (OP) 在治疗盆腔尿道结口阻塞方面表现出类似的有效性. 虽然LP的手术时间较长,但在OP内进行的背部脊椎切除术 (DL) 提供了更短的停留时间和更少的止痛需要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 儿科手术 儿科手术
背景情况:
- 盆腔尿路结 (PUJ) 阻塞是一种常见的先天性异常,需要进行手术纠正.
- 开放式皮叶整形 (OP) 是传统的手术方法.
- laparoscopic pyeloplasty (LP) 已经成为一种极少侵入性的替代方案.
研究的目的:
- 在治疗PUJ阻塞时,比较 laparoscopic pyeloplasty (LP) 与开放式 pyeloplasty (OP) 的结果.
- 为了评估手术时间,停留时间 (LOS),成功率,并发症和止痛要求.
- 为了对5岁以上的儿童进行子组分析,并比较背部腰部切口 (DL) 与腰部切口 (LI) 在OP内.
主要方法:
- 追溯审查146个肢体破碎型塑身手术病例 (2011-2016).
- 113例接受了OP,33例接受了LP.
- 收集了关于手术时间,LOS,成功率,并发症和止痛要求的数据;进行了子组分析.
主要成果:
- 成功率相似:OP的96%和LP的97%.
- 整体上,OP (127分钟) 与LP (200分钟) 的中位数手术时间显著缩短,儿童>5岁.
- 与腰部切口 (LI) 相比,在OP内进行的背部腰部切口 (DL) 显示显着较短的LOS (2天 vs. 4天) 和较少的止痛要求 (0.44 mg/kg vs. 0.64 mg/kg吗啡).
结论:
- 在治疗PUJ阻塞方面,OP和LP都同样有效.
- 整体LOS,并发症率和止痛要求在OP和LP之间没有显著差异.
- 与OP相比,LP与显著更长的操作时间有关.
相关概念视频
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
81
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
81
01:25Urinary Tract Calculi VI: Surgical Management
11
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
11
01:26Kidney Transplant II: Surgical Procedure
37
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
37
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
112
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
112