|本期目录/Table of Contents|

[1]徐梦青,马婷婷,王蓉,等.达芬奇机器人辅助腹腔镜下输尿管膀胱再植术对输尿管-回肠吻合口狭窄的临床效果分析[J].医学研究与战创伤救治(原医学研究生学报),2021,23(02):126-130.[doi:10.3969/j.issn.1672-271X.2021.02.004]
　XU Meng-qing,MA Ting-ting,WANG Rong,et al.Effect of Da Vinci robotic-assisted ureteral reimplantation on ureteral-intestinal anastomotic stenosis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2021,23(02):126-130.[doi:10.3969/j.issn.1672-271X.2021.02.004]
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达芬奇机器人辅助腹腔镜下输尿管膀胱再植术对输尿管-回肠吻合口狭窄的临床效果分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第23卷
期数:
2021年02期
页码:
126-130
栏目:
临床研究
出版日期:
2021-03-22

文章信息/Info

Title:
Effect of Da Vinci robotic-assisted ureteral reimplantation on ureteral-intestinal anastomotic stenosis
作者:
徐梦青; 马婷婷; 王蓉; 洪含霞
210029南京，江苏省人民医院泌尿外科（徐梦青、马婷婷、王蓉、洪含霞）
Author(s):
XU Meng-qing;  MA Ting-ting;  WANG Rong;  HONG Han-xia
（Department of Urology Surgery，Jiangsu Provincial Hospital，Nanjing 210029, Jiangsu, China）
关键词:
达芬奇机器人; 腹腔镜下输尿管膀胱再植术; 输尿管-回肠吻合口狭窄; 肾功能; 临床疗效
Keywords:
Da Vinci robot;  laparoscopic ureteral bladder reimplantation;  ureteral-intestinal anastomotic stenosis;  renal function;  clinical effect
分类号:
R699
DOI:
10.3969/j.issn.1672-271X.2021.02.004
文献标志码:
A
摘要:
目的探讨达芬奇机器人辅助腹腔镜下输尿管膀胱再植术（RAUR）对输尿管-回肠吻合口狭窄的应用效果。方法回顾性分析2016年1月至2019年6月期间于江苏省人民医院行RAUR的53例输尿管-回肠吻合口狭窄患者(机器人组)，并以同期于医院接受腹腔镜下输尿管膀胱再植术的53例输尿管-回肠吻合口狭窄患者（腹腔镜组）作为对照。比较2组患者的基线资料、围手术期资料、随访结果与临床疗效。结果2组患者的基线资料、术前血肌酐（Cr）、尿素氮（BUN）、胱抑素C（Cys C）、肾小球滤过率（GFR）与肾盂分离度比较，差异无统计学意义（P＞0.05）。2组患者的手术均成功完成，无一例术中输血及中转开腹。机器人组术中失血量、术后住院时间显著低于腹腔镜组（P＜0.05）。2组手术时间、术后通气时间、术后引流管留置时间、并发症的发生率等比较，差异均无统计学意义（P＞0.05）。组内比较，2组术后血Cr、BUN、Cys C水平、肾盂分离度均显著低于术前，GFR显著高于治疗前，差异均有统计学意义（P＜0.05）。组间比较，机器人组术后血Cr、BUN、Cys C水平均显著低于同期腹腔镜组（P＜0.05）。2组术后GFR、肾盂分离度比较，差异均无统计学意义（P＞0.05）。全部患者均无一例治疗无效，机器人组、腹腔镜组的治愈率分别为86.8%、75.5%，2组比较差异无统计学意义（P＞0.05）。结论达芬奇机器人辅助腹腔镜下输尿管膀胱再植术对输尿管-回肠吻合口狭窄患者是一种安全、有效的治疗选择，术后出血量更少、住院时间更短，短期预后优于常规腹腔镜手术，但在远期预后及整体疗效方面两者相当。
Abstract:
ObjectiveTo analyze the effect of Da Vinci robotic-assisted ureteral reimplantation (RAUR) on ureteral-intestinal anastomotic stenosis.MethodsFifty-three patients with ureteral-intestinal anastomotic stenosis undergone RAUR from January 2016 to June 2019 in our hospital were enrolled for the study as robot group, and 53 patients with ureteral-intestinal anastomotic stenosis undergone laparoscopic ureteral bladder reimplantation in our hospital at the same time were selected as laparoscopic group. The baseline data, perioperative data, follow-up result and clinical efficacy were compared between two groups.ResultsThere were no significant differences in baseline data, serum creatine (Cr), blood urea nitrogen (BUN), Cystatin C (Cys C) levels, glomerular filtration rate (GFR) and renal pelvis resolution before operation between two groups (P>0.05). All operations of the two groups were successfully completed, and no case of intraoperative blood transfusion and conversion to laparotomy. The intraoperative blood loss and postoperative hospital stay in the robot group were significantly lower than those in laparoscopic group (P<0.05). There were no significant differences in operation time, postoperative ventilation time, postoperative indwelling time of drainage tube and incidence of com-plicationbetween two groups (P>0.05). For intra-group comparison, the level of Cr, BUN, Cys C and resolution of renal pelvis after operation in two groups were significantly lower than those before operation, and GFR was significantly higher than that before operation (P<0.05). For inter-group comparison, the level of Cr, BUN, Cys C and resolution of renal pelvis after operation in the robot group were significantly lower than those at the same time in laparoscopic group (P<0.05), and there were no significant differences in GFR and resolution of renal pelvis after operation between two groups (P>0.05). There was no invalid treatment in all patients, and the cure rate of the robot group and laparoscopic group was 86.8% and 75.5% respectively, and there was no significant difference between them (P>0.05).ConclusionDa Vinci robotic-assisted ureteral reimplantation is a safe and effective treatment option for patients with ureteral-intestinal anastomotic stenosis. The intraoperative blood loss is less and postoperative hospital stay is shorter. Its short-term prognosis is better than that of conventional laparoscopic operation, but their long-term prognosis and the overall effect are similar.

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备注/Memo

备注/Memo:
基金项目：江苏省医药卫生科技计划项目（1536js69）
更新日期/Last Update: 2021-03-22