后腹腔镜在肾脏恶性肿瘤治疗中的应用

Experience in retroperitoneal laparoscopy for renal malignancy tumors

目的探讨后腹腔镜在肾癌、肾盂癌治疗中的手术方法及疗效。方法回顾性分析2004年1月至2009年4月间我院应用后腹腔镜技术行肾癌根治术和肾盂癌根治术的患者共254例,进行手术时间、出血量、中转开放情况、术中及术后并发症、住院时间、下床活动时间、术后肿瘤复发及转移例数等数据的统计,对术中操作步骤及手术经验进行总结。结果平均手术时间为(146±64)min,平均出血量为(230±120)ml,中转开放患者为29例(11.4%),术中出现并发症的患者24例(9.4%),术后出现并发症的患者14例(5.5%),平均住院时间(8±2)d,下床活动时间(3.0±1.2)d。术后随访4～46个月,在随访期内肿瘤复发及转移者19例(7.5%)。结论后腹腔镜在上尿路肿瘤的治疗中具有创伤小、解剖层次清晰、术中出血少、术后恢复快等优势,治疗效果与开放手术相似。

Objective To investigate the surgical technique and clinical outcomes of retroperitoneal laparoscopy in the treatment of renal cancer. Methods We retrospectively analysed the records of 254 patients who underwent retroperitoneal laparoscopic radical nephrectomy and nephroureterectomy in our hospital from January 2004 to April 2009.Variables analyzed included operative time,blood loss,turning to open operation,complications,length of hospital stay,tumor recurrence and metastasis. Results The respective mean operative duration was（146±64） min and the mean estimated blood loss was（230±120） ml.29 of all patients were transtormed to open operation（11.4%）.Length of hospital stay were（8±2） d.During the follow up period ranged from 4-46 months,19 of all cases have tumor recurrence and metastasis. Conclusions Retroperitoneal laparoscopy in renal rnalignancy tumors has small incisions,incurs less blood loss,and allows for a more rapid recovery,which indicated that it is a safe and effective method for treating patients with renal and pelvis cancer.