后腹腔镜肾癌根治术与开放手术疗效比较

A comparison study of retroperitoneal laparoscopic and open radical nephrectomy

目的 与传统开放性肾癌根治术比较,评价后腹腔镜肾癌根治术的手术方法及临床效果.方法 回顾性分析和比较2006年1月至2008年6月32例后腹腔镜肾癌根治术（A组）和34例同期开放性肾癌根治术（B组）的临床资料.结果 A、B两组手术时间分别为（156±35）min和（127±33）min,手术失血量分别为（132±75）ml和（212±43）ml,术后胃肠功能恢复时间分别为（29.6±4.7）h和（18.9±7.8）h,术后住院时间分别为（6.5±1.4）d和（3.7±3.3）d,差异均有统计学意义（P〈0.05）.结论 后腹腔镜肾癌根治术较开放性肾癌根治术在减少术中出血、加快术后恢复方面具有明显优势,可达到同样根治的效果,但手术时间长,术后胃肠功能恢复时间长,治疗费用高.

Objective To evaluate the clinical value of retroperitoneal laparoscopic and open radical nephrectomy. Methods Clinical data of 32 cases of retroperitoneal laparoseopie radical nephrectomy（ retroperitoneal group） and 34 cases of open radical nephreetomy （open group） from January 2006 to June 2008 in this hospital were retrospectively analyzed and compared in respect of operation time, inta - operative blood loss, postoperative hospitalizations, and occurrence of complications. Results The operation time was significantly longer in the retroperitoneal group than in the open group [ （ 156 ± 35 ） min vs. （127 ± 33 ） min ,P 〈 0.05 ]. The intraoperative blood loss was significantly less in the retroperitoneal group than in the open group [ （132 ± 75 ） ml vs. （212 ± 43 ） ml, P 〈 0.05 ]. The recovery time for gastrointestinal function was significantly longer in the retroperitoneal group than that in the open group [ （29.6 ± 4.7 ） h vs. （ 18.9 ± 7.8 ） h, P 〈 0.05 ]. The postoperative hospital stay was significantly shorter in the retroperitoneal group than in the open group [ （ 6.5 ± 1.4 ） d vs. （ 13.7 ± 3.3 ） d, P 〈 0.05 ]. Conclusion Radical retroperitoneal laparoscopic nephrectomy is superior to open nephrectomy in the treatment for kidney carcinoma in terms of intraoperative blood loss and postoperative recovery rather than the operation time, the recovery time for gastrointestinal function and the surgical cost.