The Application Of Transumbilical Three-stab Laparoscopic Anderson-Hynes Surgica-1 Treatment Of Ureteropelvic Junction Obstruction In Children

[RESEARCH BACKGROUND]Hydronephrosis,is a more common pediatric urinary system congenital malformations.Clinically,nearly 90%of the hydronephrosis is caused by UPJO(ureteropelvic junction obstruction)caused.Treatment of pediatric hydronephrosis,including conservative treatment and surgical treatment.Surgical treatment is the most widely used Anderson-Hynes(off-type pyeloplasty)surgery,the operation once appeared immediately became the standard operation of hydronephrosis.Open renal pelvic lithotripsy treatment of ureteropelvic junction obstruction of a one-time success rate can reach more than 90%.And the literature reported laparoscopic treatment of pediatric hydronephrosis in the one-time success rate and open surgery quite.But the retroperitoneal approach still exists in the surgical space is small,not suitable for the treatment of complex or re-operation of children with hydronephrosis,surgical scar is still more obvious shortcomings[PURPOSE]The aim of this study was to investigate the clinical efficacy and prognosis of pediatric laparoscopic cholecystectomy in the treatment of pediatric hydronephrosis and compare the advantages and disadvantages of the retroperitoneal laparoscopic approach,and explore the surgical approach for the treatment of UPJO Caused by the clinical value of pediatric hydronephrosis.[METHOD]Total 59 patients with unilateral severe hydronephrosis caused by UPJO were diagnosed by ultrasound,MRU examination from September 2012 to April 2014,and the follow-up time was 6-12 months.Divided into experimental group and control group:the experimental group(the umbilical three-channel laparoscopic approach in 34 cases),the control group(retroperitoneal approach 25 cases).The operative group and control group were divided into two groups:sex,age of operation and age of kidney,operation time,intraoperative blood loss,operation mode,mean hospitalization day,preoperative and postoperative renal pelvis,(Glomerular filtration rate).And the two groups of data were analyzed statistically.[RESULT]Two groups of children were successfully completed the operation,surgery did not change the open surgery,no serious complications of surgery,no deaths,two groups of 1 case of postoperative review prompted again obstruction,no recurrence after surgery again,then The data for the second patient were based on the data for the second operation.The follow-up period was 6-12 months.In the experimental group and the control group,the data of the renal pelvis and the glomerular filtration rate before and after the operation were compared with the two samples.The P values were less than 0.05,which indicated that there were significant differences between the two groups before and after the operation.Pathway surgery effective.Finally,the difference between the two groups of data difference between the two pairs of samples t test,the test results showed that all indicators before and after treatment were no significant difference(P>0.05).Indicating that the two surgical approach to treatment by the UPJO caused by severe hydronephrosis in children with no significant difference in efficacy[CONCLUSION]The three-channel laparoscopic cholecystectomy of the pyeloplasty was similar to that of the retroperitoneal laparoscopic approach,and the operative space was larger,and the advantages of the secondary or multiple operation were more obvious.The postoperative wound scar was not obvious.Better results,with a greater clinical value.