手助腹腔镜与标准腹腔镜根治性肾切除术的临床研究

Gasless Laparoscopic and Standard Laparoscopic Clinical Study of Radical Nephrectomy

目的：对比手助腹腔镜与标准腹腔镜根治性肾切除术手术与预后情况,探讨手助腹腔镜优势与缺陷。方法：回顾性分析经病理证实为T1-T2NOMO并采用腹腔镜手术治疗患者临床资料,采用手助腹腔镜手术患者41例纳入观察组,采用标准腹腔镜手术患者43例纳入对照组,对比临床资料。结果：观察组患者肛门排气时间（2.6±0.5）d、住院时间（11.3±3.8）d高于对照组（2.1±0.6）min、（8.4±2.5）d,手术时间（128.4±23.1）min、术中出血量（82.0±54.4）ml低于对照组患者（184.5±57.2）min、（210.4±164.3）ml,两组比较差异均有统计学意义（P〈0.05）。两组患者均未见严重并发症,随访12个月~4年,均未见肿瘤复发。结论：相较于标准腹腔镜,手助腹腔镜手术可有效缩短手术时间、减少术中出血量,但可能增加排气时间、延长住院时间,两种手术并发率、复发率均较低。

Objective：To compare gasless laparoscopic with standard laparoscopic radical nephrectomy surgery and prognosis condition,and discuss gasless laparoscopic advantages and defects.Method：Patients＇ clinical data of laparoscopic operation were analyzed retrospectively and patients were confirmed by T1-T2 NOMO,41 patients with gasless laparoscopic surgery as observation group,43 patients with standard laparoscopic surgery as control group,their clinical data was compared.Result：It showed that exhaust time（2.6±0.5）d,hospital stay time（11.3±3.8）d of observation group were higher than（2.1±0.6）min、（8.4±2.5）d of control group.operation time（128.4±23.1）min,intraoperative blood loss,（82.0±54.4）ml were lower than（184.5±57.2）min and（210.4±164.3）ml of control group,and the difference between the two groups were statistically significant（P〈0.05）.All patients never appeared serious complications.followed up for 4~12 months,tumor recurrence was not found.Conclusion：Compared with standard laparoscopic,gasless laparoscopic surgery can effectively shorten the operation time,reduce intraoperative blood loss,but it may increase exhaust time,extend the length of time. Two concurrent operation rate,recurrence rates are low.