Comparison of clinical efficacy between gas-bladder laparoscopic Cohen procedure versus laparoscopic extravesical ureterovesical replantation for malformation of vesicoureteral junction

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.02.005

Moudong Wu, Jin-pu Peng, Huixia Zhou, X. Zhan, Yuangui Yang, Daniel Wang, Nini An

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引用次数: 0

Abstract

Objective To compare the efficacy of gas-bladder laparoscopic Cohen procedure versus laparoscopic extravesical ureterovesical replantation for malformation of vesicoureteral junction in children. Methods From February 2014 to August 2019, gas-bladder laparoscopic Cohen procedure (n=17) and laparoscopic extravesical ureterovesical replantation under submucosal tunnel (n=14) were performed for unilateral malformation of vesicoureteral junction.Detailed clinical data were reviewed, including operative duration, postoperative time of intravenous antibiotic, postoperative hematuria time, length of urethral catheterization, postoperative hospitalization and hospital expenditure.A comparative study of major clinical parameters was performed. Results The mean operative duration of both groups was (194±46) and (152±52) min, the mean hospitalization stay was(8.1±1.1) and (6.4±1.2) days and the mean postoperative hematuria time was (3.2±0.7) and (1.5±1.1) days respectively.All of the above parameters had significant differences.The postoperative antibiotic dosing time was (5.6±1.1) and (5.2±1.2) days, the average time of indwelling catheter was(6.3±1.3) and (5.5±1.2) days and the mean hospital expenditure was(23357.2±4638.5) and (21194±3518.2) yuan respectively.No statistical differences existed in the above parameters.There was no conversion into open surgery in either groups.After a follow-up period of 3-12 months, the preoperative symptoms disappeared.For 13 cases in gas-bladder laparoscopic Cohen group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). The outcomes were postoperative urinary tract infection (n=1), mild ureteral dilation (n=1) and ureteral reflux II (n=1); For 11 cases in laparoscopic extravesical ureterovesical replantation group, ultrasound showed that hydronephrosis disappeared and ureter normalized (n=10). There was mild ureteral dilation (n=1) without ureteral reflux. Conclusions Clinical efficacies of both procedures are definite for obstruction of vesicoureteral junction in children.As compared with gas-bladder laparoscopic Cohen procedure, laparoscopic extravesical ureterovesical replantation is less time-consuming and more mini-invasive and recovers faster. Key words: Urinary bladder; Laparoscopes; Ureteral reimplantation

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气囊腹腔镜Cohen手术与腹腔镜输尿管膀胱外再植术治疗膀胱输尿管连接处畸形的临床疗效比较

目的比较气囊腹腔镜Cohen手术与腹腔镜输尿管膀胱外再植术治疗儿童膀胱输尿管连接处畸形的疗效。方法2014年2月至2019年8月，对单侧膀胱输尿管交界处畸形行腹腔镜Cohen手术(n=17)和粘膜下隧道下腹腔镜输尿管膀胱外再植术(n=14)。回顾详细的临床资料，包括手术时间、术后静脉抗生素时间、术后血尿时间、导尿时间、术后住院时间和住院费用。进行了主要临床参数的比较研究。结果两组患者平均手术时间分别为(194±46)min和(152±52)min，平均住院时间分别为(8.1±1.1)天和(6.4±1.2)d，平均术后血尿时间分别为(3.2±0.7)天和(1.5±1.1)d。以上参数均有显著性差异。术后抗生素给药时间分别为(5.6±1.1)天和(5.2±1.2)天，平均留置导管时间分别为(6.3±1.3)天和(5.5±1.2)天，平均住院费用分别为(23357.2±4638.5)元和(21194±3518.2)元。以上参数均无统计学差异。两组患者均未转为开腹手术。随访3-12个月，术前症状消失。气囊腹腔镜Cohen组13例，超声显示肾积水消失，输尿管正常(n=10)。结果为术后尿路感染(n=1)、轻度输尿管扩张(n=1)和输尿管反流II (n=1);腹腔镜输尿管膀胱外再植术组11例超声显示肾积水消失，输尿管正常(n=10)。有轻度输尿管扩张(n=1)，无输尿管反流。结论两种术式治疗儿童膀胱输尿管交界处梗阻疗效确切。与气囊腹腔镜Cohen手术相比，腹腔镜输尿管膀胱外再植时间更短，微创性更强，恢复更快。关键词:膀胱;镜头辅助;输尿管再植术

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.