METHODS: A retrospective analysis of the clinical data of 95 patients treated for ureteral stricture at Ganzhou People\'s Hospital from June 2017 to March 2023 after pelvic surgery. In this group, 49 patients underwent ureteroscope and laparoscopic ureteroplasty under lithotomy position. The control group consisted of 46 patients who underwent simple laparoscopic ureteroplasty in a supine position. Postoperative data from both groups were collected and compared, including operation time, amount of blood loss during surgery, postoperative hospital stay, incidence of complications, success rate of ureteroplasty, and effectiveness of the operation.
RESULTS: The success rate of end-to-end ureteral anastomosis in the observation group was 93.88%, and the operation effectiveness rate was 100%. The success rate in the control group was 78.26% and the operation effectiveness rate was 89.1%.The average operation time and intraoperative blood loss in the observation group were (121.3 ± 44.6) min and (137.5 ± 34.2) ml, respectively, while in the control group they were (151.2 ± 52.3) min and (165.6 ± 45.8) ml, the difference were statistically significant (P < 0.05). The incidence of perioperative complications in the observation group was 2%, significantly lower than that in the control group (19.6%) (P < 0.05).
CONCLUSIONS: Ureteroscope-assisted laparoscopic ureteroplasty for ureteral stricture after pelvic surgery has the advantages of shortened operation time, increased success rate, and reduced incidence of complications, making it an optional surgical scheme in clinical practice.
方法:回顾性分析2017年6月至2023年3月赣州市人民医院行盆腔手术治疗的95例输尿管狭窄患者的临床资料。在这个群体中,49例患者在截石位下行输尿管镜及腹腔镜输尿管成形术。对照组包括46例仰卧位进行简单腹腔镜输尿管成形术的患者。收集并比较两组患者术后数据,包括操作时间,手术过程中的失血量,术后住院时间,并发症的发生率,输尿管成形术的成功率,和操作的有效性。
结果:观察组端端端输尿管吻合成功率为93.88%,手术有效率为100%。对照组手术成功率为78.26%,手术有效率为89.1%。观察组平均手术时间和术中出血量分别为(121.3±44.6)min和(137.5±34.2)ml,分别,对照组分别为(151.2±52.3)min和(165.6±45.8)ml,差异有统计学意义(P<0.05)。观察组围手术期并发症发生率为2%,显著低于对照组(19.6%)(P<0.05)。
结论:输尿管镜辅助腹腔镜输尿管成形术治疗盆腔术后输尿管狭窄具有缩短手术时间的优点。成功率提高,减少并发症的发生率,使其成为临床实践中的可选手术方案。