后腹膜腹腔镜与开放性肾癌根治术的临床对比

Comparison of the retroperitoneal laparoscopic radical nephrectomy and the open radical nephrectomy

目的比较后腹膜腹腔镜肾癌根治术与传统开放手术治疗效果及术后恢复情况。方法行后腹腔镜肾癌根治术34例（后腹腔镜组），常规开放手术行肾癌根治术34例（开放手术组），比较两种方法手术时间、出血量、住院时间、血气分析、胃肠功能恢复时间、下床活动时间及切口种植转移情况。结果后腹腔镜组手术时间（87．8±20．12）min，出血量（113．2±28．8）ml，术后胃肠功能恢复时间（23．9±3．85）h，下床活动时间（34．6±4．26）h。开放手术组手术时间（124．1±37．45）min，出血量（222．3±95．7）ml，术后胃肠功能恢复时间（40．4±5．23）h，下床活动时间（57．7±8．95）h。2组手术时间、出血量、住院时间、胃肠功能恢复时间、下床活动时间比较均有统计学意义（均P〈0．05）；2组血气分析均正常且无切口种植转移。结论后腹腔镜肾癌根治术手术效果优于开放手术。

Objective To compare the effect of retroperitoneal laparoscopic radical nephrectomy and open radical nephrectomy. Methods 34 cases underwent retroperitoneal laparoscopic radical nephrectomy and 34 cases underwent open radical nephrectomy. The operation time,b：tood loss,hospital stay, CO2 absorption, postoperative ileus, the time for walking and the implantation metastasis of cut were comparatively studied. Results In retroperitoneal laparoscopic radical nephrectomy the operative time was （87.8 ±20.12 ） min, the average blood loss was （ 113. 2 ± 288 ） ml, and the recovery time of bowel function was （23.9 ± 3.85 ） h, the time for the patients to walk freely was （34.6 ± 4.26 ） h. In open radical nephrectomy the operative time was （ 124.1 ± 37.45 ） min, the average blood loss was （222.3 ± 95.7 ） ml, and the recovery time of bowel function was （40.4 ±5.23 ） h, the time for the patients to walk freely was （ 57.7 ± 8.95 ） h. There was significance in operation time, blood loss, hospital stay, heavery time and walking time between the two groups （ P 〈 0.05 ）. NO abnormal blood gas ouurred and there was no metastasis. Conclusion Retroperitoneal laparoscopic radical nephrectomy is superior to open radical nephrectomy.