后腹腔镜肾部分切除术治疗T1a期肾细胞癌的疗效分析

Analysis of Clinical Efficacy of Retroperitoneal Laparoscopic Partial Nephrectomy in the Treatment of T1a Renal Cell Aarcinoma

目的探讨后腹腔镜肾部分切除术用于T1a期肾细胞癌的安全性与可行性。方法回顾性分析24例T1a期肾细胞癌施行后腹腔镜下肾部分切除术患者和30例T1a期肾细胞癌并施行开放性肾切除术患者的临床资料,比较两组患者手术时间、术中出血量、引流管放置时间、胃肠活动时间、住院费用以及住院时间,比较两组术后并发症以及1年随访情况。结果后腹腔镜组术中出血量明显低于开放组(P<0.05),胃肠功能恢复时间后腹腔镜组明显短于开放组(P<0.05)。两组患者手术时间和引流管放置时间比较无统计学意义(P>0.05),住院时间后腹腔镜组患者明显少于开放组(P<0.05)。住院费用后腹腔镜组明显高于开放组(P<0.05),术中需要输血患者两组差异明显(P<0.05)。结论后腹腔镜肾部分切除术用于T1a期肾细胞癌可最大限度的保留功能性肾单位,有利于患者术后恢复,近期疗效肯定。

Objective To study the safety and feasibility of retroperitoneal laparoscopic partial nephrectomy in the treatment of T1a renal cell carcinoma.Methods We analyzed the clinical data of 24 cases of T1a renal cell carcinoma underwent retroperitoneal laparoscopic partial nephrectomy and 30 patients with T1a renal cell carcinoma treated by open nephrectomy and compared the operation time,intraoperative bleeding volume,indwelling time of drainage tube,gastrointestinal activity time,hospitalization expenses,hospitalization time,postoperative complications and follow-up of 1 year between the two groups.Results The intraoperative bleeding volume of the retroperitoneal laparoscopic partial nephrectomy group was significantly lower than that of the open group（P 〈 0.05）.The recovery time of the retroperitoneal laparoscopic partial nephrectomy group was significantly shorter than that of the open group（P 〈0.05）.The operation time and indwelling time of drainage tube in the two groups showed no statistical significance（P〉 0.05）.The hospitalization time of the retroperitoneal laparoscopic partial nephrectomy group was significantly less than that of the open group（P 〈 0.05）.The hospitalization expenses of the retroperitoneal laparoscopic partial nephrectomy group were significantly higher than those of the open group（P〈 0.05）.The patients needing blood transfusion during operation were significantly difference between the two groups（P 〈 0.05）.Conclusions The retroperitoneal laparoscopic partial nephrectomy for T1a renal cell carcinoma can maximize the retention of functional renal unit and is conducive to postoperative recovery.