后腹腔镜和开放肾部分切除术的临床效果比较

Comparison of clinical effects between retroperitoneal laparoscopic partial nephrectomy and open partial nephrectomy

目的比较后腹腔镜和开放肾部分切除术的临床效果。方法回顾分析2003年1月～2007年6月该院后腹腔镜肾部分切除术15例,开放肾部分切除术28例,比较两种手术方法的手术时间、出血量、住院时间、术前和术后肌酐水平、并发症、手术效果的差别。结果后腹腔镜和开放手术组平均手术时间分别为(118.7±27.9)min和(199.0±41.9)min(P<0.01),平均出血量分别为(112.4±42.4)mL和(269.6±151.5)mL(P<0.01),术后拔除肾周引流管平均时间分别为(7.0±1.4)d和(7.8±2.3)d(P>0.05),平均住院时间分别为(13.2±3.0)d和(17.7±4.0)d(P<0.01),肿块平均直径分别为(2.02±0.4)cm和(3.49±0.8)cm(P<0.01)。开放手术组有2例患者为孤立肾而行保留肾单位手术,后腹腔镜组没有孤立肾患者。术前和术后平均血清肌酐水平后腹腔镜组为88.8!mol/L和97.0"mol/L,开放手术组为97.1#mol/L和106.0$mol/L。两组并发症的发生没有差别。随访3～20个月,开放手术组出现局部复发1例。结论后腹腔镜肾部分切除术较同期开放肾部分切除术手术时间短,解剖清晰,出血少,住院时间短,拔除引流管时间和手术效果相当。

[Objective] To compare the clinical effects of retroperitoneal laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN). [Methods] We retrospectively analysed the records of all patients who underwent partial nephrectomy in our hospital from January 2003 to June 2007, identifying 15 who had LPN and 28 who had OPN. Variables analysed included operative time, blood loss, length of stay, creatinine levels before and after partial nephrectomy, complications, operation effect. Groups were compar...