Лапароскопик (ЛП) ва очиқ усулдаги пиелопластика (ОП) натижаларини таққослаш. Республика ихтисослашган урология марказида 2010-2015 йилларда бажарилган 35 та ЛП ва 50 та ОП жаррохлик амалиётларини ретроспектив таҳлили. Биз ЛП ва ОП ларни таққослаганда қўйидагилар аниқладик: жаррохлик амалиёти ўртача давомийлиги ЛП учун 163 дақиқа- ОП учун эса 103дақиқа (р<0.01), жаррохлик амалиёти давомида қон йўқотиш ЛП учун 31 мл - ОП учун эса 132 мл (р<0.01). Амалиётдан кейинги даврда ишлатилган оғриқсизлантирувчи дорилар миқдори (диклофенак) ЛП учун 75 мг- ОП учун эса 300 мг (р<0.01), жаррохлик кесмаси ўртача узунлиги ЛП учун 1,6 см- ОП учун эса 17 см (р<0.01), кундалик овқатланиш режимига қайтиш вақти ЛП учун 22 соат - ОП учун эса 30 соат (р<0.01), касалхонада ётиш кунлари ўртача ЛП учун 3 кун - ОП учун эса 8 кун(р<0.01). Жаррохлик амалиёти давомидаги асоратлар 5,7 % ЛП учун (2 та беморга тери орқали нефростомия қўйишга тўғри келди, сийдик паравазацияси туфайли) ва ОП учун эса 6% (3 беморда гипертермия кузатилгани боис қўшимча дори воситалари ишлатишга тўғри келди).Жаррохлик амалиётидан 6 ой ўтиб, ОП гуруҳдаги 17 беморда (34%) эса бел соҳасида «чандиқли оғриқларга» шикоят борлиги аниқланди, айни вақтда ЛП гуруҳдаги беморларда бундай ҳолат 4 беморда(11,4%) кузатилди. Жаррохлик амалиётидан кейинги даврда чандиқли оғриқларни камлиги ЛП ни жом сийдик найи сегменти торайишига чалинган беморларни даволашда самарали усул эканлигини кўрсатди.
Comparison of results of laparoscopic (LP) and open(OP) pyeloplasties. We compare retrospectively 35 patients who undergone LP with 50 OP in period from 2010 till 2015y. In comparative analysis of LP and OP we conclude that: mean operative time for LP and OP was 163 min versus 103 (P<0.01), blood loss 31ml versus 132 ml (P<0.01), dosage of used analgesics (diclofenac) after procedure 75mg versus 300 mg (P<0.01), average length of incision 1.6 CM versus 17CM (P<0.01), shortening of hospital stay days 3 versus 8 days (P<0.01), early returning to normal feed state 22 hours versus 30 hours (P<0.01). Intraoperative complications in LP group has been 5.7 % (two patients has been needed for PCN in early postoperative days because of excessive urine leakage from paranephral drain tube) and 6% for OP (3 patients had high temperature which need additional drug requirement).17 patients (34%) in open group had pain in lumbar area “scar pain” after 6th month of operation. In that time only 4(11.4%) of patients from LP had such kind of pain. High effectiveness and low degree of pain in post operative wound makes LP more attractive in treatment of uretero-pelvic junction obstruction.
| № | Имя автора | Должность | Наименование организации |
|---|---|---|---|
| 1 | Akilov F.A. | ||
| 2 | Muxtarov S.T. | ||
| 3 | Ayubov B.A. | ||
| 4 | Baxadirxanov M.M. | ||
| 5 | Nazarov J.A. | ||
| 6 | Xashimov R.A. |
| № | Название ссылки |
|---|---|
| 1 | Inagaki T, Rha KH, Ong AM, Kavoussi LR, Jarrett TW (2005) Laparoscopic pyeloplasty: current status. BJU Int 95(Suppl 2): 102–105. |
| 2 | Mandhani A, Kumar D, Kumar A, Kapoor R, Dubey D, Srivastava A, Bhandari M (2005) Safety profile and complications of transperitoneal laparoscopic pyeloplasty: a critical analysis. J Endourol 19: 797–802. |
| 3 | Moon DA, El-Shazly MA, Chang CM, Gianduzzo TR, Eden CG (2006) Laparoscopic pyeloplasty: evolution of a new gold standard. Urology 67: 932–936. |
| 4 | Zhang X, Li HZ, Wang SG, Ma X, Zheng T, Fu B, Zhang J, Ye ZQ (2005) Retroperitoneal Ф.А. Акилов, Ш.Т. Мухтаров, Б.А. Аюбов, М.М. Бахадирханов, Дж.А. Назаров, Р.А. Хашимов Биология ва тиббиёт муаммолари, 2016, №1 (86) 19 laparoscopic dismembered pyeloplasty: experience with 50 cases. Urology 66: 514–517] а так же не рандомизированные сравнение [2. Bauer JJ, Bischoff JT, Moore RG, Chen RN, Iverson AJ, Kavoussi LR (1999) Laparoscopic versus open pyeloplasty: assessment of objective and subjective outcome. J Urol 162: 692–695 |
| 5 | Bonnard A, Fouquet V, Carricaburu E, Aigrain Y, El-Ghoneimi A (2005) Retroperitoneal laparoscopic versus open pyeloplasty in children. J Urol 173: 1710–1713. |
| 6 | Davenport K, Minervini A, Timoney AG, Keeley FX Jr (2005) Our experience with retroperitoneal and transperitoneal laparoscopic pyeloplasty for pelvi-ureteric junction obstruction. Eur Urol 48: 973–977. |
| 7 | Desai MM, Desai MR, Gill IS (2004) Endopyeloplasty versus endopyelotomy versus laparoscopic pyeloplasty for primary ureteropelvic junction obstruction. Urology 64: 16–21. |
| 8 | Klingler HC, Remzi M, Janetschek G, Kratzik C, Marberger MJ (2003) Comparison of open versus laparoscopic pyeloplasty techniques in treatment of uretero-pelvic junction obstruction. Eur Urol 44: 340–345. |
| 9 | Ost MC, KKaye JD, Guttman MJ, Lee BR, Smith AD (2005) Laparoscopic pyeloplasty versus antegrade endopyelotomy: comparison in 100 patients and a new algorithm for the minimally invasive treatment of ureteropelvic junction obstruction. Urology 66: 47–51. |
| 10 | Soulie M, Thoulouzan M, Seguin P, Mouly P, Vazzoler N, Pontonnier F, Plante P (2001) Retroperitoneal laparoscopic versus open pyeloplasty with a minimal incision: comparison of two surgical approaches. Urology 57: 443–447 |
| 11 | Zhang X, Li HZ, Ma X, Zheng T, Lang B, Zhang J, Fu B, Xu K, Guo XL (2006) Retrospective comparison of retroperitoneal laparoscopic versus open dismembered pyeloplasty for ureteropelvic junction obstruction. J Urol 176: 1077–1080. |