后腹腔镜根治性肾切除术治疗肾癌的临床疗效分析

Analysis of Clinical Efficacy of Retroperitoneal Laparoscopic Radical Nephrectomy for the Treatment of Kidney Cancer

【目的】探讨后腹腔镜帮助下根治性肾切除治疗肾癌患者的效果。【方法】本院174例患有肾癌并实施根治性肾切除术的患者，将其分为两组，观察组的84例患者应用后腹腔镜下根治性肾切除术，对照组的90例应用常规的开放性根治性肾切除术，比较两组患者手术所需时间、术中出血量、术后住院时间、术后肠道恢复以及术后并发症发生情况。【结果】两组患者的手术均取得成功，两组手术患者的手术时间相比较无明显差异（P〉0．05）。但观察组患者和对照组相比术中出血量少、术后并发症发生率低及肠道恢复时间短，且两组相比差异均有显著性（P〈0．05）。两组患者均未出现严重的并发症，实施开放性手术的患者有4例进行了输血。对所有患者进行了3～36个月的随访，平均为9个月，观察组有2例出现肝转移最终死亡，对照组患者中有4例出现了远处转移而死亡。【结论】后腹腔镜根治性肾切除术治疗肾癌具有为患者创伤小，术后恢复快，出现的并发症较少等优点，不失为一种安全、有效的治疗方法。

Objective To explore the efficacy of retroperitoneal laparoscopic radical nephrectomy for the treatment of patients with kidney cancer. KMethods~ Totally 174 patients with kidney cancer undergoing radical nephrecto- my in our hospital were divided into two groups. The observation group（ n = 84） underwent retroperitoneal laparo- scopic radical nephrectomy, while the control group（ n=90） underwent conventional open radical nephrectomy. The operation time, intraoperative blood loss, postoperative hospital stay, postoperative intestinal recovery and postopera- tive complications were compared between two groups. [Resultsl All patients in two groups were operated successful- ly. There was no significant difference in the operation time between two groups（P^0. 05）, but the patients in ob- servation group had less intraoperative blood loss, lower postoperative complications and shorter intestinal recovery time compared with the control group, and there was significantly difference（ P 〈0.05）. No severe complication occurred in two groups. Blood transfusion was performed in 4 patients undergoing open surgery. All patients were followed up for 3 to 36 months with an average of 9 months. Two patients in observation group died of fiver metastasis. Four patients in control group died of distant metastasis. [ConclusionlRetroperitoneal laparoscopic radical nephrectomy for the treatment of patients with kidney cancer has advantages such as small trauma, rapid postoperative recovery and fewer complications, so it is a safe and effective treatment method.