南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (01): 148-.

• • 上一篇    

3D与2D后腹腔镜输尿管切开取石的手术效果比较

陈庆科,刘久敏,冼志勇,徐战平,罗耀雄,陈汉忠,叶楚津   

  • 出版日期:2016-01-20 发布日期:2016-01-20

Comparison of the effect of three-dimensional versus two-dimensional retroperitoneal
laparoscopic ureter lithotomy

  • Online:2016-01-20 Published:2016-01-20

摘要: 目的探讨3D腹腔镜在输尿管切开取石手术的手术效果及其优劣势。方法收集2014年1月~2015年5月在我院行输尿
管切开取石患者45例,通过简单随机分为3D腹腔镜25例,2D腹腔镜20例。对于手术过程进行片段式的模块切割统计,对每一
步骤的耗时进行独立统计分析。对比分析术中术野暴露时间、放管时间、缝合时间等手术操作指标。结果45例患者均手术成
功,术后3.0±0.8 d拔除伤口引流管,术后1周拔除尿管出院,术后1个月膀胱镜拔除双J管,随访3月,复查IVP(静脉泌尿系造影)
未见输尿管吻合口狭窄。手术步骤的模块耗时分析显示,3D组的每一关键操作步骤均比2D的耗时要少,且均优于2D组,统计
学均有意义(P<0.05)。3D腹腔镜在手术精细操作过程中明显优于2D组,3D立体感给予术者如开放手术般的纵深感觉,使抓持
及缝合进针、绕线等精细操作的流畅度得到提高,从而缩短了手术操作时间。结论3D腹腔镜作为新技术应用于外科微创手术
当中,不仅给患者带来了微创的获益,而且使术者在舒适操作、快速响应及精细操作方面均有获益。

Abstract: Objective To compare the surgical effect of three-dimensional (3D) versus 2D laparoscopic surgery in ureter
lithotomy. Methods From January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to
undergo ureter lithotomy under 3D laparoscopy (25 cases) and 2D laparoscopy (20 cases). The time used for each surgical
process (including the exposure, D-J tube discharge, suture and other surgical procedures) was recorded and compared
between the two groups. Results The operation was completed smoothly in all the 45 patients. In this cohort, the wound
drainage tube was removed in a mean of 3.0 ± 0.8 days after the operation, the catheter was removed after a week, and the
double J tube was removed at 1 month. Follow-up intravenous pyelography at 3 months after the operation reveal ureteral
stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was
significantly shorter in the 3D group than in the 2D group (P<0.05). 3D laparoscopic surgery allowed more precise operation
by providing a good sense of depth as in an open surgery to reduce the operation time. Conclusion As a minimally invasive
surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in
ureter lithotomy.