开放根治性和腹腔镜下肾切除术对比分析

Experience of 25 Cases Laparoscopic Nephrectomy Atergo

目的：对比分析开放根治性和后腹腔镜肾切除术的手术效果。方法：回顾对比分析2009年10月-2012年4月行开放根治性肾切除术28例和后腹腔镜肾切除术25例,观察手术时间、术中出血量,术后胃肠恢复时间,术后住院时间等情况。结果：开放根治性肾切除术手术时间为65-250 min平均155 min。后腹腔镜肾切除术手术时间70-240 min,平均152 min。两者不具有统计学差异（P〉0.05）。开放根治性肾切除术手术术中出血200~1000mL,平均600 mL。后腹腔镜肾切除术手术术中出血50-320 mL,平均165 mL。两者具有统计学差异（P〈0.05）。开放根治性肾切除术手术术后胃肠功能恢复时间48-98 h,平均74 h;术后住院时间7-12 d,平均10 d。后腹腔镜肾切除术手术术后胃肠功能恢复时间18-72 h,平均35 h;术后住院时间4-8 d,平均7 d。两者具有统计学差异（P〈0.05）。结论：后腹腔镜下手术肾切除具有创伤小、出血少、恢复快等优点,但对适应症选择方面应慎重。

Objective： To analysis the difference between open radical and laparoscopic nephrectomy surgery effect. Methods：Review of comparative analysis between 28 cases open radical nephrectomy and 25 cases of laparoscopic nephrectomy from October2009 to April 2012, the operation time, intraoperative blood loss, postoperative gastrointestinal recovery time and postoperative hospital stay, and so on were observed. Results： The time of open radical nephrectomy surgery was 65~250 min on average 155 min compared to70~240 min on average 152 min in laparoscopic nephrectomy surgery（P0.05）. Intraoperative hemorrhage in open radical nephrectomy surgery ranged from 200 to 1000 ml, 600 mL on average, rather the Laparoscopic nephrectomy surgery bled 50-320 mL, an average of165 mL, which has statistical difference（P 0.05）. Postoperative gastrointestinal function recovery time after open radical nephrectomy was 48 ~ 98 h, 74 h average; Postoperative hospital stay was 7~12 d, 10 d average. While postoperative gastrointestinal function recovery time after laparoscopic nephrectomy was 18~72 h, an average of 35 h; Postoperative hospital stay of 4~8 d, 7 d average. Which has statistical difference（P0.05）. Conclusion： After laparoscopic nephrectomy surgery with small trauma, less bleeding, faster recovery, but the indications selection should be careful.