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Background:Retroperitoneal laparoscopic nephropexy has been applied to nephroptosis. Weinvestigate the approach and treatment effect of retroperitoneal laparoscopicnephropexy. Methods: From May 1990 to October 2013, 45 patients withnephroptosis treated in our hospital were retrospectively analyzed. Among them,25 patients underwent nephropexy open surgery group, the other 20 patientsunderwent retroperitoneal laparoscopic nephropexy laparoscopic surgerygroup. In open surgery group, there were 24 females and 1 male, aged 20 -35 years. In laparoscopic surgery group, there were 19 females and 1 male, aged20 - 35 years. All of them with nephroptosis of the right kidney werecombined with lower back pain or hematuria and underwent intravenouspyelography IVP and color ultrasound in orthostatic and supineposition for a specific diagnosis. In open surgery group, patients underwentopen surgery. Their kidneys were fully dissociated, then, the upperand middle pole of the dorsal kidneywas sutured with lumbar fascia for two stitches forfixation respectively. While in laparoscopic surgery group, kidneyswere fully dissociated in Gerota’s fascia during laparoscopic surgery,and the upper pole of the dorsal kidney was sutured withthe lumbar fascia for two stitches using a 2-0 absorbablesuture. They were all in the supine position for a week aftersurgery. The body mass index BMI, operation time, bleeding amount, postoperativehospital stay, wound complication rate and other indicators were comparedbetween two groups. Results: BMI in open surgery group was 16.77 ± 0.80kg-m2, BMI in laparoscopic surgery group was 16.73 ± 0.78 kg-m2, P >0.05 showed no statistical difference; the operation time in open surgery groupwas 70.96 ± 10.61 min, that in laparoscopic surgery group was 34.65 ± 4.87min, P < 0.001 showed highly statistical significance; thebleeding amount in open surgery group was 20.65 ± 6.48 ml, that in laparoscopicsurgery group was 4.85 ± 1.63ml, P < 0.001 showed highlystatistical significance; the postoperative hospital stay in open surgery groupwas 7.54 ± 1.28 d, that in laparoscopic surgery group was 7 d, P >0.05 showed no statistical difference. In open surgery group, four patientshad wound infection which delayed the healing, and the wound complicationrate was 16% 4-25. In laparoscopic surgery group, wound complicationsdid not appear, the incidence was 0%, X2 = 1.8144, P >0.05 showed no statistical difference. The mean follow-up visit lasted 1.5years after surgery 3 months to 2 years, B-mode ultrasound in orthostatic andsupine position showed kidneys were in the normal position. Compared with thosebefore surgery, postoperative uncomfortable symptoms completely disappeared inall patients. Conclusions: Retroperitoneal laparoscopic nephropexy has a goodeffect on symptomatic nephroptosis. The two stitches of suturebetween the upper pole of the dorsal kidney and the lumbar fasciashow convenient operation, less damage and faster postoperativerecovery, which are better than open surgery.

KEYWORDS

Nephroptosis, Retroperitoneoscopic, Nephropexy

Cite this paper

Wei, R. 2014 Clinical Experience in the Treatment of Nephroptosis Using Retroperitoneal Laparoscopic Nephropexy. Open Journal of Urology, 4, 78-81. doi: 10.4236-oju.2014.46013.





Autor: Ruojing Wei

Fuente: http://www.scirp.org/



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