后腹腔镜下肾癌根治术与开放式肾癌根治术的疗效比较

Comparative study of retroperitoneal laparoscopic radical nephrectomy and open radical nephrectomy in patients with renal cell carcinoma

目的比较后腹腔镜下肾癌根治术与开放式肾癌根治术的治疗效果。方法回顾性分析38例后腹腔镜下肾癌根治术(后腹腔镜组)及49例开放式肾癌根治术(开放手术组)患者的临床资料,比较两种术式在手术时间、术中出血量、术后下床活动时间及术后住院时间等方面差异。结果两组患者在性别、年龄、肿瘤位置、肿瘤大小及肿瘤分级等方面的差异无统计学意义(P>0.05)。后腹腔镜组平均手术时间为(148.8±39.1)min,长于开放手术组[(132.3±37.1)min],但二者比较差异无统计学意义(P>0.05)。后腹腔镜组术中出血量为(92.2±23.7)mL,开放手术组术中出血量为(288.3±35.5)mL,二者比较差异有统计学意义(P<0.05)。后腹腔镜组下床活动时间[(69.8±9.2)h]及术后住院时间[(6.1±1.4)d]均明显优于开放手术组[(32.6±10.2)h、(8.9±1.9)d,P<0.05]。术后随访2个月至2年,两组患者均无肿瘤复发。结论后腹腔镜下肾癌根治术与开放式肾癌根治术相比,前者具有术中出血少、创伤小、恢复快、住院时间短等优点。

Objective To compare the clinical efficacy of retroperitoneal laparoscopic radical nephrectomy （RLRN） versus open radical nephrectomy （ORN） in patients with renal cell carcinoma .Methods Clinical data of 38 patients receiving RLRN （RLRN group） and 49 patients receiving ORN （ORN group） were retrospectively analyzed for the comparison of operative time ,blood loss ,time to ambulation and postoperative hospital stay .Results There were no significant differences between the two groups about sex ,age ,tumor location ,tumor size and tumor grade .No significant difference was noted in average operating time between RLRN group [（148 .8 ±39 .1）min] and ORN group [（132 .3 ±37 .1）min ,P〉0 .05] .The difference of blood loss between RLRN group [（92 .2 ±23 .7）mL ] and ORN group [（288 .3 ±35 .5）mL] was significant （P〈0 .05） .There were significant differences of time to ambulation and postoperative hospital stay between RLRN group [（69 .8 ±9 .2）h and （6 .1 ±1 .4）d respectively ] and ORN group [（32 .6 ±10 .2）h and （8 .9 ±1 .9）d respectively ,P〈 0 .05] .There was no case with disease recurrence in the two groups during follow-up of 2 months to 2 years .Conclusion Compared with ORN ,RLRN might be with advantages of mild pain ,less blood loss ,rapid recovery and short hospital stay .