腹腔镜下改良乳头输尿管再植术

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.02.004

Aiwu Li, X. Cui, Jian Wang, Qiangye Zhang, Feng-yin Sun, Weijing Mu, Peimin Hou, Jiawei Chen, Guowei Li

{"title":"腹腔镜下改良乳头输尿管再植术","authors":"Aiwu Li, X. Cui, Jian Wang, Qiangye Zhang, Feng-yin Sun, Weijing Mu, Peimin Hou, Jiawei Chen, Guowei Li","doi":"10.3760/CMA.J.ISSN.0253-3006.2020.02.004","DOIUrl":null,"url":null,"abstract":"Objective \nTo introduce pneumovesicoscopic orthotopic modified nipple ureteral reimplantation for megaureter and to compare its safety, feasibility and application with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation. \n \n \nMethods \nFrom January 2010 to March 2019, retrospective analysis was performed for clinical data of retrograde cystography and complications during pneumovesicoscopic orthotopic modified nipple ureteral reimplantation.The potential advantages and disadvantages were compared with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation.One hundred and seventy-nine cases were reviewed and analyzed in 3 groups.In open group, there were 44 boys and 19 girls.The age was under 6 months (n=32), 6 months to 1 year (n=23) and older than 1 year (n=8). The sideness was left (n=30), right (n=17) and bilateral (n=16). There were primary obstructive megaureter (POM, n=58), vesicoureteral reflux (VUR, n=4) and POM & VUR (n=1). And the outcomes were hydronephrosis (n=53), infection (n=33), ectopic ureteral orifice (n=7) and ureter cyst (n=3); In pneumovesicoscopic Cohen group, there were 38 boys and 17 girls.The age was under 6 months (n=10), 6 months to 1 year (n=5) and above 1 year (n=40). The sideness was left (n=27), right (n=13) and bilateral (n=15). There were POM (n=50), VUR (n=3) and POM & VUR (n=2). And the outcomes were hydronephrosis (n=44), infection (n=38), ectopic ureteral orifice (n=2) and ureter cyst (n=3); In pneumovesicoscopic modified nipple group, there were 36 boys and 25 girls.The age was under 6 months (n=22), 6 months to 1 year (n=28) and older than 1 year (n=11). The sideness was left (n=33), right (n=19) and bilateral (n=9). There were POM (n=50), VUR (n=7) and POM & VUR (n=4). And the outcomes were hydronephrosis (n=61), infection (n=56), ectopic ureteral orifice (n=3) and ureteral caecum (n=1). \n \n \nResults \nAll cases of ureteral reimplantation were performed successfully.Pneumovesicoscopic operations were performed with only 2 cases of Cohen procedure converting into open surgery.No significant differences existed between pneumovesicoscopic Cohen procedure and pneumovesicoscopic orthotopic modified nipple procedure in operative duration (97.2±49.4 vs 77.4±37.0 min, P>0.05), volume of blood loss (3.7±1.5 vs 2.9±1.8 ml, P>0.05) and hospitalization stay (6.8±2.3 vs 6.2±1.3 days, P>0.05) with an equivalent postoperative antireflux efficacy and without severe complications.As compared with open surgery, pneumovesicoscopy offered longer operative duration (P<0.05), less volume of blood loss (P<0.05), shorter hospitalization stay (P<0.05) and fewer complications. \n \n \nConclusions \nPneumovesicoscopic orthotopic modified nipple ureteral reimplantation is an anatomic orthotopic ureteral reimplantation with remarkable antireflux and clinical efficacies.It is an alternative treatment for refluxing and obstructed megaureter. \n \n \nKey words: \nChild; Ureteral obstruction; Laparoscopes; Ureteral reimplantation","PeriodicalId":10157,"journal":{"name":"中华小儿外科杂志","volume":"65 1","pages":"112-117"},"PeriodicalIF":0.0000,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pneumovesicoscopic modified orthotopic nipple ureteral reimplantation\",\"authors\":\"Aiwu Li, X. Cui, Jian Wang, Qiangye Zhang, Feng-yin Sun, Weijing Mu, Peimin Hou, Jiawei Chen, Guowei Li\",\"doi\":\"10.3760/CMA.J.ISSN.0253-3006.2020.02.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective \\nTo introduce pneumovesicoscopic orthotopic modified nipple ureteral reimplantation for megaureter and to compare its safety, feasibility and application with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation. \\n \\n \\nMethods \\nFrom January 2010 to March 2019, retrospective analysis was performed for clinical data of retrograde cystography and complications during pneumovesicoscopic orthotopic modified nipple ureteral reimplantation.The potential advantages and disadvantages were compared with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation.One hundred and seventy-nine cases were reviewed and analyzed in 3 groups.In open group, there were 44 boys and 19 girls.The age was under 6 months (n=32), 6 months to 1 year (n=23) and older than 1 year (n=8). The sideness was left (n=30), right (n=17) and bilateral (n=16). There were primary obstructive megaureter (POM, n=58), vesicoureteral reflux (VUR, n=4) and POM & VUR (n=1). And the outcomes were hydronephrosis (n=53), infection (n=33), ectopic ureteral orifice (n=7) and ureter cyst (n=3); In pneumovesicoscopic Cohen group, there were 38 boys and 17 girls.The age was under 6 months (n=10), 6 months to 1 year (n=5) and above 1 year (n=40). The sideness was left (n=27), right (n=13) and bilateral (n=15). There were POM (n=50), VUR (n=3) and POM & VUR (n=2). And the outcomes were hydronephrosis (n=44), infection (n=38), ectopic ureteral orifice (n=2) and ureter cyst (n=3); In pneumovesicoscopic modified nipple group, there were 36 boys and 25 girls.The age was under 6 months (n=22), 6 months to 1 year (n=28) and older than 1 year (n=11). The sideness was left (n=33), right (n=19) and bilateral (n=9). There were POM (n=50), VUR (n=7) and POM & VUR (n=4). And the outcomes were hydronephrosis (n=61), infection (n=56), ectopic ureteral orifice (n=3) and ureteral caecum (n=1). \\n \\n \\nResults \\nAll cases of ureteral reimplantation were performed successfully.Pneumovesicoscopic operations were performed with only 2 cases of Cohen procedure converting into open surgery.No significant differences existed between pneumovesicoscopic Cohen procedure and pneumovesicoscopic orthotopic modified nipple procedure in operative duration (97.2±49.4 vs 77.4±37.0 min, P>0.05), volume of blood loss (3.7±1.5 vs 2.9±1.8 ml, P>0.05) and hospitalization stay (6.8±2.3 vs 6.2±1.3 days, P>0.05) with an equivalent postoperative antireflux efficacy and without severe complications.As compared with open surgery, pneumovesicoscopy offered longer operative duration (P<0.05), less volume of blood loss (P<0.05), shorter hospitalization stay (P<0.05) and fewer complications. \\n \\n \\nConclusions \\nPneumovesicoscopic orthotopic modified nipple ureteral reimplantation is an anatomic orthotopic ureteral reimplantation with remarkable antireflux and clinical efficacies.It is an alternative treatment for refluxing and obstructed megaureter. \\n \\n \\nKey words: \\nChild; Ureteral obstruction; Laparoscopes; Ureteral reimplantation\",\"PeriodicalId\":10157,\"journal\":{\"name\":\"中华小儿外科杂志\",\"volume\":\"65 1\",\"pages\":\"112-117\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-02-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华小儿外科杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.004\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华小儿外科杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.0253-3006.2020.02.004","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

目的介绍腹腔镜下原位改良乳头输尿管重建术，并比较其与开放输尿管重建术、腹腔镜下Cohen输尿管重建术的安全性、可行性及应用价值。方法回顾性分析2010年1月至2019年3月我院气管镜下原位改良乳头输尿管再植术逆行膀胱造影及并发症的临床资料。比较开放输尿管再植术与腹腔镜下输尿管再植术的优缺点。将179例病例分为3组进行回顾性分析。公开组男生44人，女生19人。年龄6月龄以下32例，6月龄~ 1岁23例，1岁以上8例。侧边为左侧(n=30)、右侧(n=17)和双侧(n=16)。原发性梗阻性脉管炎(POM, n=58)、膀胱输尿管反流(VUR, n=4)和POM + VUR (n=1)。结果:肾积水53例，感染33例，输尿管口异位7例，输尿管囊肿3例;腹腔镜Cohen组男38例，女17例。年龄6月龄以下(n=10)、6月龄~ 1岁(n=5)、1岁以上(n=40)。侧边为左侧(n=27)、右侧(n=13)和双侧(n=15)。有POM (n=50)、VUR (n=3)和POM & VUR (n=2)。结果为肾积水(44例)、感染(38例)、输尿管口异位(2例)、输尿管囊肿(3例);气管内镜下改良乳头组男36例，女25例。年龄为6月龄以下22例，6月龄~ 1岁28例，1岁以上11例。左侧(n=33)、右侧(n=19)和双侧(n=9)。其中POM (n=50)， VUR (n=7)， POM & VUR (n=4)。结果为肾积水61例，感染56例，输尿管口异位3例，输尿管盲肠1例。结果所有输尿管再植术均成功。经腹腔镜手术，科恩手术转为开放手术仅2例。两组手术时间(97.2±49.4 min vs 77.4±37.0 min, P>0.05)、出血量(3.7±1.5 ml vs 2.9±1.8 ml, P>0.05)、住院时间(6.8±2.3 d vs 6.2±1.3 d, P>0.05)差异无统计学意义，术后抗反流效果相当，无严重并发症。与开放手术相比，肺内镜手术时间更长(P<0.05)，出血量更少(P<0.05)，住院时间更短(P<0.05)，并发症更少。结论气管镜下原位改良乳头输尿管再植术是一种解剖式原位输尿管再植术，具有显著的抗反流效果和临床疗效。这是一种治疗反流和阻塞的方法。关键词:儿童;输尿管梗阻;镜头辅助;输尿管再植术

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Pneumovesicoscopic modified orthotopic nipple ureteral reimplantation

Objective To introduce pneumovesicoscopic orthotopic modified nipple ureteral reimplantation for megaureter and to compare its safety, feasibility and application with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation. Methods From January 2010 to March 2019, retrospective analysis was performed for clinical data of retrograde cystography and complications during pneumovesicoscopic orthotopic modified nipple ureteral reimplantation.The potential advantages and disadvantages were compared with open or pneumovesicoscopic Cohen cross-trigonal ureteral reimplantation.One hundred and seventy-nine cases were reviewed and analyzed in 3 groups.In open group, there were 44 boys and 19 girls.The age was under 6 months (n=32), 6 months to 1 year (n=23) and older than 1 year (n=8). The sideness was left (n=30), right (n=17) and bilateral (n=16). There were primary obstructive megaureter (POM, n=58), vesicoureteral reflux (VUR, n=4) and POM & VUR (n=1). And the outcomes were hydronephrosis (n=53), infection (n=33), ectopic ureteral orifice (n=7) and ureter cyst (n=3); In pneumovesicoscopic Cohen group, there were 38 boys and 17 girls.The age was under 6 months (n=10), 6 months to 1 year (n=5) and above 1 year (n=40). The sideness was left (n=27), right (n=13) and bilateral (n=15). There were POM (n=50), VUR (n=3) and POM & VUR (n=2). And the outcomes were hydronephrosis (n=44), infection (n=38), ectopic ureteral orifice (n=2) and ureter cyst (n=3); In pneumovesicoscopic modified nipple group, there were 36 boys and 25 girls.The age was under 6 months (n=22), 6 months to 1 year (n=28) and older than 1 year (n=11). The sideness was left (n=33), right (n=19) and bilateral (n=9). There were POM (n=50), VUR (n=7) and POM & VUR (n=4). And the outcomes were hydronephrosis (n=61), infection (n=56), ectopic ureteral orifice (n=3) and ureteral caecum (n=1). Results All cases of ureteral reimplantation were performed successfully.Pneumovesicoscopic operations were performed with only 2 cases of Cohen procedure converting into open surgery.No significant differences existed between pneumovesicoscopic Cohen procedure and pneumovesicoscopic orthotopic modified nipple procedure in operative duration (97.2±49.4 vs 77.4±37.0 min, P>0.05), volume of blood loss (3.7±1.5 vs 2.9±1.8 ml, P>0.05) and hospitalization stay (6.8±2.3 vs 6.2±1.3 days, P>0.05) with an equivalent postoperative antireflux efficacy and without severe complications.As compared with open surgery, pneumovesicoscopy offered longer operative duration (P<0.05), less volume of blood loss (P<0.05), shorter hospitalization stay (P<0.05) and fewer complications. Conclusions Pneumovesicoscopic orthotopic modified nipple ureteral reimplantation is an anatomic orthotopic ureteral reimplantation with remarkable antireflux and clinical efficacies.It is an alternative treatment for refluxing and obstructed megaureter. Key words: Child; Ureteral obstruction; Laparoscopes; Ureteral reimplantation

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

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.