单孔后腹腔镜根治性肾切除术与标准后腹腔镜根治性肾切除术的对比研究

Comparative study of retroperitoneal laparoendoscopic single-site radical nephrectomy with standard laparoscopic radical nephrectomy

目的：通过与标准后腹腔镜根治性肾切除术进行对照研究，评估单孔后腹腔镜根治性肾切除术的临床疗效.方法：2011年4月~2012年8月，行单孔后腹腔镜根治性肾切除术53例，随机选择同一时期行标准后腹腔镜根治性肾切除术53例，将两组资料的临床及病理指标进行对照研究.结果：两组病例的术后切口引流管拔除时间分别为(3.20±1.45)d 和(3.80±1.80)d ，术后住院天数分别为(6.60±1.50)d 和(7.30±1.82)d ，均差异有统计学意义(P ＜0．05).两组病例的性别、年龄、体质指数、手术时间、手术失血量、术后第1、2、3天的切口引流量、手术部位、肿瘤位置、肿瘤大小、TNM 分期、Fuhr man 分级、术中术后并发症均差异无统计学意义(P ＞0．05).两组各有1例患者中转开放手术.结论：与标准后腹腔镜比较，单孔后腹腔镜根治性肾切除术安全可行，可缩短住院时间，具有较好的美容效果.

To assess the clinicalefficacy of retroperitoneallaparoendoscopic single-site radicalnephrec-to my (LESSRN)versus standard laparoscopic radicalnephrecto my (SLAN).Methods :Bet ween April201 1 and Au-gust 201 2 ,53 patients with renalcancer in our center under went retroperitoneal LESSRN by using a ho me made sin-gle- port device ,and during the sa me peri od ,53 cases undergoing SLAN were rando mly analyzed .The clinicaland pathologicalpara meters of the t wo groups were analyzed ,including gender ,age ,body mass index ,operati ve ti me , esti mated blood loss ,drainage volu me of the wound ,wound drainage tube re moval,hospitalstay ,operati ve si de , tu mor size ,tu mor locati on ,clinicalTNMstage ,Fuhr man grade ,and co mplicati ons .Results :No si gnificant differ-ences were found in gender ,age ,body mass index ,operati ve ti me ,esti mated blood loss ,operati ve si de ,tu mor size , tu mor locati on ,clinicalTNMstage ,Fuhr man grade ,and co mplicati ons bet ween t wo groups (P >0 .05 ).The ti me of wound drainage tube re movaland hospitalstay in the LESSRN group were si gnificantly shorter than in SLAN group (P <0 .05 ).Conclusions :Co mpared with SLAN ,retroperitonealLESSRN using a ho me made single- port device is a safe and feasi ble procedure for manage ment of localized renalcancer ,and have provi ded a better cos metic outco me and shorter hospitalstays .