后腹腔镜联合下腹部斜行小切口在上尿路尿路上皮癌根治术中的应用

The application of the retroperitoneal laparoscopy combined with the abdominal small incision in the radical resection of the upper urinary tract urothelial carcinoma

目的 探讨分析后腹腔镜联合下腹部斜行小切口在上尿路尿路上皮癌根治术中的应用.方法 选取2006年1月-2013年11月在本院接受治疗的上尿路尿路上皮癌患者72例,随机将其分为两组,治疗组和对照组各36例,对照组患者行开放性根治术;治疗组患者行后腹腔镜联合下腹部斜行小切口切除术,对两组患者的临床疗效进行比较.结果 所有患者均手术成功;治疗组患者的平均手术时间,术中出血量、术后肠功能恢复时间及平均住院时间均小于对照组患者（P＜0.05）,且治疗组皮下气肿发生率显著高于对照组（P＜0.05）;对照组其他的相关并发症发生率显著高于治疗组（P＜0.05）.结论 后腹腔镜联合下腹部斜行小切口在上尿路尿路上皮癌根治术中疗效好,手术时间短,对患者造成的创伤小,术后恢复较快,术后并发症少,优势明显,可在临床中推广使用.

Objectives Discuss and analyze the application of the retroperitoneal laparoscopy combined with the abdominal small incision in the radical resection of the upper urinary tract urothelial carcinoma.Methods 72 cases of upper urinary tract urothelial carcinoma diagnosed at our hospital were chosen from January 2006 to January 2013.72 patients were randomly divided into thetreatment group and control group,each group included 36 cases.The patients in the control group were given open radical resection;the patients in the treatment group were given retroperitoneal laparoscopy combined with the abdominal small incision radical resection.The clinical efficacy of the patients was compared in two groups.Results All the patients were operated successfully;the mean operation time,peri-operative bleeding volume,the time of gastrointestinal function recovery and average hospital stay of the patients in the treatment group were shorter than those of the control group.The differences between the treatment group and control group were statistically significant（P ＜0.05）,and the incidence of subcutaneous emphysema in the treatment group was significantly higher than that in control group（P ＜0.05） ;The control group was significantly higher than in other related complication rate （P ＜ 0.05）.Conclusions The retroperitoneal laparoscopy combined with the abdominal small incision in the radical resection of the upper urinary tract urothelial carcinoma has good efficacy,short operation time,less trauma and quick recovery from operation and is worth to clinical applied.