Abstract：Objective To study the effect of mesenteric approach and retroperitoneal approach laparoscopic pyeloplasty in children with hydronephrosis, and to analyze the effects on the levels of renal blood flow in peak systolic velocity(PS), time average maximal velocity (TAMx), end diastolic peak velocity (ED) and time avarage minimum velocity(TAMn). Methods The clinical data of 117 children with hydronephrosis who received laparoscopic pyeloplasty in Shenyang Children′s Hospital from October 2018 to October 2020 were retrospectively analyzed. According to the difference of surgical approach, they were divided into group A (55 cases) and group B (62 cases). The mesenteric approach was adopted in group A, and the retroperitoneal approach was adopted in group B. The postoperative hydronephrosis and improvement of partial renal function, operative index level, PS, TAMx, ED and TAMn levels were compared between the two groups. Results There was no statistically significant difference in the improvement of postoperative hydronephrosis between the two groups (P>0.05). There was no statistically significant difference in the improvement of postoperative renal function between the two groups (P>0.05). The duration of operation in group A was longer than that in group B, and the intraoperative blood loss was less than that in group B, the differences were statistically significant (P<0.05). After treatment, the levels of PS, TAMx, ED and TAMn in group A were higher than those in group B, the differences were statistically significant (P<0.05). Conclusion Laparoscopic pyeloplasty via mesocolonic approach in the treatment of hydronephrosis in children has shorter operation duration, less intraoperative blood loss,and can effectively improve the level of renal hemodynamic indicators in children.
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