后腹腔途径与经腹途径腹腔镜下切除巨大囊状无功能肾的临床比较

Clinical efficacy evaluation of retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis

目的 评价后腹腔途径与经腹途径腹腔镜下切除巨大囊状无功能肾的技术方法和临床应用价值。方法回顾性分析后腹腔途径（后腹腔途径组，26例）与经腹途径（经腹途径组，23例）腹腔镜下切除巨大囊状无功能肾的临床资料，比较两种方法的手术时间、肾脏体积、术中失血量、术后肠功能恢复时间、住院时间及手术效果。结果两组手术均获成功。两组手术时间、肾脏体积、术中失血量比较差异无统计学意义（P〉0，05）。后腹腔途径组术后肠功能恢复时间、住院时间明显少于经腹途径组[（18．0±1．2）h比（48．0±2．0）h，（5．5±1．6）d比（7．5±1．6）d]（P〈0．05）。49例患者术后随访1～3个月，未见异常。结论后腹腔途径与经腹途径腹腔镜下切除巨大囊状无功能肾均是微创和安全有效的治疗方法，后腹腔途径在术后恢复方面优于经腹途径。

Objective To evaluate the technical feasibility and clinical efficacy of retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis. Methods The clinical data of retroperitoneal group （26 patients） and transperitoneal group （23 patients） Who underwent laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis were analyzed retrospectively. Compared with operating time, kidney size, blood loss, postoperative intestinal function recovery time, postoperative hospital stay and operative efficacy of the two groups. Results All the operations were performed successfully. Operating time,kidney size and blood loss were not significantly different between two groups（P〉 0.05 ）. While in retroperitoneal group, postoperative intestinal function recovery time and postoperative hospital stay were significandy reduced than those in transperitoneal group [ （18.0 ±1.2） h vs. （48.0 ±2.0） h, （5.5± 1.6） d vs. （7.5 ± 1.6） d] （P 〈 0.05）. All patients were followed up 1 - 3 months,no abnormal. Conclusions The retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis can be performed efficiently and effectively. Retroperitoneal laparoscopic is better than transperitoneal laparoscopic on postoperative recovery aspects.