后腹腔镜肾部分切除术治疗小肾癌的临床效果研究

Comparative study of clinical effect on open and laparoscopic partial nephrectomy treatment for small renal cell carcinoma

目的探讨后腹腔镜（LPN）肾部分切除术治疗小肾癌的临床效果及安全性。方法回顾性分析我院2008年3月至2012年3月65例小肾癌患者行肾部分切除术的临床资料，其中35例行开放。肾部分切除术（OPN组），30例行后腹腔镜肾部分切除术（RLPN组），比较分析2组手术时间、术中出血量、热缺血时间、住院时间、病理切缘阳性率和并发症发生率。结果OPN组和RLPN组平均肿瘤大小差别无统计学意义，RLPN组较OPN组出血少、手术时间短、住院时间短，且不增加热缺血时间。2组均无切缘阳性，术后2组。肾功能均无受损表现，随访6—18个月均无复发。结论后腹腔镜肾部分切除术具有手术时间短、出血量少、术后住院时间短等优点，而且不会延长热缺血时间，临床效果与开放肾部分切除术相同。

Objective To compare the safety and clinical effect of laparoscopic partial nephrectomy （LPN） on small renal cell carcino- ma. Methods The records of 65 patients who underwent partial nephrectomy in our hospital from March 2008 to March 2013 were retrospec- tively analyzed. 35 patients were given open partial nephrectomy and the other 30 patients were given LPN. Compared the operative time, blood loss ,warm isehemia time, length of stay, positive marginrate, and oceurance rate of complications between the two groups. Results There wasno statistical difference in the mean size of tumor in the two groups. Compared to the OPN group, there was less blood loss, operative time, hospital stays and warm ischemia time in the LPN group. There was neither positive surgical margin nor renal function damage in the two groups. And during the follow-up period ranged from 6 to 18 months, there was no local recurrence. Conclusion Laparoscopic partial ne- phrectomy has a shorter operation time,less blood loss, shorter length of hospital stay compared with open partial nephrectomy, and it wouldn t extend the time of warm ischemia,while the clinical effect of the two methods are similar.