临床外科杂志 ›› 2024, Vol. 32 ›› Issue (2): 144-147.doi: 10.3969/j.issn.1005-6483.2024.02.008

• 论著 • 上一篇    下一篇

经尿道棒状电极等离子电切术与尿道端端吻合术治疗短段尿道狭窄早期临床疗效比较

  

  1. 050000  石家庄,联勤保障部队第九八0医院泌尿外科(原白求恩国际和平医院)(张剑飞、邱建宏、赵新鸿);石家庄医学高等专科学校(沈鹤)
  • 收稿日期:2023-03-03 修回日期:2023-03-03 接受日期:2023-03-03 出版日期:2024-02-20 发布日期:2024-02-20
  • 基金资助:
    河北省卫计委课题项目(20170944)

Comparison of the clinical effect of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture

  1. Department of Urology Surgery,The 980th Hospital of the Joint Logistics Support Force of PLA,Bethune International Peace Hospital,Hebei,Shijiazhuang 050000,China
  • Received:2023-03-03 Revised:2023-03-03 Accepted:2023-03-03 Online:2024-02-20 Published:2024-02-20

摘要: 目的 探讨经尿道棒状电极等离子电切术与尿道端端吻合术治疗短段尿道狭窄早期临床疗效。方法 2014年1月~2020年12月本院收治的男性短段尿道狭窄病人125例,根据手术方式的不同分为经尿道棒状电极等离子电切术(微创组)和尿道端端吻合术(开放组)。进一步根据尿道狭窄长度的不同,将微创组分为微创一组(狭窄段长度≤1cm)和微创二组(狭窄段长度1~2cm),开放一组(狭窄段长度≤1cm)和开放二组(狭窄段长度1~2cm)。比较4组之间的手术成功率。结果 微创一组与开放一组手术成功率分别为88.57%和93.10%,两组比较,差异无统计学意义(P>0.05)。微创二组与开放二组手术成功率分别为67.86%和90.91%,微创二组手术成功率低于开放二组,差异有统计学意义(P<0.05)。微创一组与微创二组手术成功率分别为88.57%和67.86%,差异有统计学意义(P<0.05)。开放一组与开放二组手术成功率分别为93.10%和90.91%,差异无统计学意义(P>0.05)。结论 对于狭窄段长度≤1cm尿道狭窄,因经尿道棒状电极等离子电切术与开放手术手术成功率相同,手术创伤小,恢复快,因此首选经尿道棒状电极等离子电切术微创治疗。对于1~2cm尿道狭窄,微创手术创伤小,恢复快,但开放手术成功率更高,手术方式的选择需权衡利弊,综合考虑。

关键词: 等离子电切术, 棒状电极, 尿道狭窄, 尿道端端吻合术

Abstract: Objective To investigate the clinical efficacy of transurethral plasma electrotomy with rod electrode and end-to-end urethral anastomosis in the treatment of short urethral stricture.Methods 125 male patients with short urethral stricture (<2 cm) who were admitted to our hospital from January 2014 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into transurethral plasma resection with rod electrode (minimally invasive group) and urethral end-to-end anastomosis (open group).According to the length of urethral stricture,the minimally invasive group was divided into minimally invasive group 1 (stricture length ≤1cm),minimally invasive group 2 (stricture length12cm),open group 1 (stricture length ≤1cm) and open group 2 (stricture length 12cm).The four groups were compared with each other,and the surgical success rates were compared between the four groups.Results The success rate of the minimally invasive group 1 and the open group 1 was 88.57% and 93.10%,respectively.There was no significant difference between the two groups (P>0.05).The surgical success rate of the minimally invasive group 2 and the open group 2 was 67.86% and 90.91%,respectively.The surgical success rate of the minimally invasive group 2 was significantly lower than that of the open group 2.The difference was statistically significant (P<0.05).The surgical success rate of minimally invasive group 1 and minimally invasive group 2 was 88.57% and 67.86%,respectively,the difference was statistically significant (P<0.05).The success rate of operation in the open group 1 and the open group 2 was 93.10% and 90.91%,respectively,and there was no significant difference between the two groups (P>0.05).Conclusion Transurethral plasma resection with rod electrode is preferred for urethral stricture with length ≤1cm,because the success rate of this surgery is the same as that of open surgery,and the surgical trauma is small and the recovery is fast.For 12cm urethral stricture,minimally invasive surgery has less trauma and faster recovery,but open surgery has a higher success rate.The choice of surgical method needs to weigh the advantages and disadvantages and take comprehensive consideration.

Key words: plasma electrotomy, rod electrode, urethral stricture, end-to-end urethral anastomosis 

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