腹腔镜与开放手术半肾切除治疗成人重复肾的疗效比较

Comparison of laparoscopic and open partial nephrectomy for adult patients with duplex kidney

目的:比较腹腔镜与开放手术半肾切除治疗成人重复肾的疗效。方法:回顾性分析32例成人重复肾患者的临床资料,其中男8例,女24例,年龄18～77岁。开放手术组20例,腹腔镜手术组12例。开放组平均年龄33.8岁,男4例,女16例;腹腔镜组平均年龄43.8岁,男4例,女8例。两组患者年龄差异无统计学意义(P>0.05)。结果:腹腔镜组无中转开放手术,开放手术组发生术后出血、尿外渗各1例,腹腔镜手术组术中术后均未发生外科并发症。开放手术组平均手术时间165.3min,手术前后血红蛋白差均值20.3g/L,术后首日引流量均值106.8ml,引流天数平均7.2天,住院天数平均10.1天;腹腔镜组对应的数值分别为261.4min、13.7g/L、43.8ml、3.3天、6.9天。两组患者5项数据差异均有统计学意义(P<0.05)。结论:半肾切除术是治疗成人重复肾的首选方式,腹腔镜较之开放手术具有疼痛轻、创伤小、出血少、恢复快等优点。

Objective：To compare the treatment outcome of laparoscopic and open partial nephrectomy for du- plex kidney in adults. Method：Clinical data of 32 cases of duplex kidney in adults were analysed retrospectively, of them 8 cases were male, 24 eases were female. The age ranged from 18 to 77. They were divided into 2 groups. （）pen group consisted of 20 patient~, and laparoscopic group consisted of 12 patients. In open group, there were 4 male and 16 female with the averag ~ age of 33.8 years old. In laparoscopie group, there were 4 male and 8 female with the average age of 43.8 years old. There were no significant differences in ages between groups. Result.. No conversion to open. surgery and no complication occurred in laparoscopic group. There were 2 complications （hem- orrhage and urine leakage） in open group. Mean duration of operation was 165.3min for open group, the differ- ence of pre-and post-operation hemoglobin was 20.3 g/L, the volume of first-day drainage was 106.8 ml, the time of drainage was 7.2 d and mean hospitalization was 10.1 d. In laparoscopic group, the figures were 261.4 rain, 13.7 g/L, 43.8 ml, 3.3 d and 6.9 d respectively. The differences of the figures were significant between the 2 groups（ P d0.05）. Conclusion： Partial nephrectomy is the initial option in the treatment of duplex kidney in a- dults. Laparoscopic has the benefits of slighter pain, mini-invasion, less blood loss and shorter recovery compared with open surgery.