手助腹腔镜与标准腹腔镜根治性肾切除术的临床研究

Comparison of Hand-assisted and Standard Laparoscopic Radical Nephrectomy

目的探讨手助腹腔镜根治性肾切除术与标准腹腔镜根治性肾切除术的临床价值。方法回顾分析2010年1月至2011年12月本中心96例腹腔镜根治性肾切除术患者的临床资料,其中58例为手助腹腔镜组,38例为标准腹腔镜组。对比分析两组患者的术中、术后相关临床指标、并发症及短期随访结果。结果手助腹腔镜组和标准腹腔组的手术时间(65.3min和95.8min)、术中出血量(48.9ml和123.9ml)有明显统计学差异(P<0.05)。所有病例均进行了3～27个月的随访,均未发现肿瘤局部复发或远处转移。结论手助腹腔镜技术保留了腹腔镜手术创伤小、痛苦少、术后恢复快、并发症少等优点,并可缩短手术时间、减少术中出血及损伤周围脏器的风险。

Objective To explore the clinical value of hand-assisted laparoscopic and standard laparoscopic radical nephrectomy. Methods 96 patients who underwent laparoscopic radical nephrectomy in our center from January 2010 to December 2011 were retrospectively analyzed. Hand-assisted laparoscopic radical nephrectomies were performed in 58 patients, and standard laparoscopic radical nephrectomies were performed in the rest. We compare the clinical indicators of intra-and post-operation, complications and short-term follow-up results between the two groups to explore the clinical value of the two surgical techniques. Results Compared to standard laparoscopic group, the hand-assisted laparoscopic group had obviously shorter operation time (65.3±20.9 vs 95.8±33.7min) and less intra-operative blood loss (48.9±39.8 vs 123.9±72.7min). 3~27months of follow-up of all cases, no local recurrence or distant metastasis were found. Conclusions As a useful and necessary complement of the standard laparoscopic technique, hand-assisted laparoscopic technique retain the merit of laparoscopic surgery with less trauma, less pain, quick recovery, and short operation time, and reduce bleeding and the risk of damage surrounding organs.