腹腔镜LESS肾盂成形术后患者肾功能恢复情况
作者：Brian R. Harrow, Aditya Bagrodia, Ephrem O. Olweny, Stephen Faddegon, et al. 来源：Journal of Urology 日期：2013-03-12
导读
Renal Function Outcomes Following Laparoendoscopic Single-Site (LESS) Pyeloplasty
Abstract
Purpose
Outcomes following laparoendoscopic single-site (LESS) pyeloplasty are limited to small cohort studies with short-term follow up.Within this study we evaluated the clinical and renal function outcomes of the largest LESS pyeloplasty cohort to date with a mean follow-up of 12 months.
Methods
Consecutive patients diagnosed with symptomatic ureteropelvic junction obstruction that underwent robotic LESS (R-LESS) or conventional LESS (C-LESS) pyeloplasty were entered into the study. Patient demographics, preoperative, and postoperative renal function outcomes were recorded. Postoperative diuretic renograms (DRG) were performed after stent removal, then at 6 months, and yearly thereafter.
Results
The cohort included 31 C-LESS and 22 R-LESS pyeloplasties. Conversion to other procedures occurred in 4 LESS surgeries due to failure to progress (7.8%). Mean follow-up was 12.1 ± 10.7 months,with 22 patients having at least 12 month follow-up.No intraoperative complications occurred. Postoperative complications occurred in 11 (21%) patients. Of these, 9 were ≥ Clavien Grade 3. Resolution of preoperative symptoms was achieved in 96% (49/51) of cases. Severe obstruction (defined as T1/2 >20 min) was seen in 73% (32/44) of patients at presentation and resolution of obstruction (T1/2 = 20 min) was documented in 93% (41/44) of cases. Mean preoperative T ½ was 24.6 ± 13.4 min and mean postoperative T ½ was 8.3 ± 4.1 min for an improvement of 16.3 ± 12.3 min (p<0.01).
Conclusions
LESS pyeloplasty is safe and efficacious. Both laparoscopic and robotic LESS provides excellent outcomes in terms of symptomatic relief and radiographic resolution of obstruction.
http://www.jurology.com/article/S0022-5347(13)00378-9/abstract
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