经腹腔与腹膜后行腹腔镜肾癌根治术的比较

Transperitoneal versus retroperitoneal laparoscopic radical nephrectomy

目的:比较经腹腔和腹膜后方式行腹腔镜肾癌根治术的优缺点。方法:随机将60例肾癌患者分别经腹腔或腹膜后方式行腹腔镜下肾癌根治术,比较两组术中、术后的情况。结果:与经腹腔方式比较,腹膜后方式处理肾动脉平均时间、处理肾静脉平均时间、总的手术平均时间较短。但经腹膜和腹膜后方式在估计出血量、术后住院时间、术中并发症和术后并发症发生率上无明显差异。结论:腹腔镜下经腹腔或腹膜后方式行肾癌根治术均有效,但后者在处理肾门和总的手术时间方面更快。

Objective： To compare the efficacy of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for renal tumor. Methods： Sixty patients with renal tumor were randomized to undergo either a transperitoneal （28 patients） or retroperitoneal （32 patients） laparoscopic radical nephrectomy, and then the intraoperative and postoperative data in both approaches were compared. Results： Compared with the transperitoneal approach, the retroperitoneal approach was associated with a shorter time to renal artery control, shorter time to renal vein control and shorter total operation time. However, the transperitoneal and retroperitoneal approaches were similar in terms of estimated blood loss, hospitalization after operation, intraoperative complications and postoperative, complications. Conclusions： Laparoscopic radical nephrectomy can be performed efficiently and effectively with the transperitoneal or the retropefitoneal approach, while the latter is more effective than the former for treatment of renal hilar and total operation time.