3D和2D高清腹腔镜技术在肾脏切除术中的应用比较

Comparison of 3D and 2D HD laparoscopic technique in the kidney resection

目的比较3D和2D高清腹腔镜技术在肾脏切除术中的应用效果。方法采用Storz 3D高清腹腔镜技术完成肾脏切除术32例（观察组）,回顾性分析并与2013年1月-2013年12月采用Storz 2D高清腹腔镜技术完成肾脏切除术37例（对照组）,记录手术时间、术中出血量、并发症、术后引流量、术后拔除引流管时间、术后住院时间和住院费用等,并进行统计学分析。结果观察组32例和对照组37例均顺利完成手术。前后两组手术时间为（124.41±52.90）和（149.00±33.68）min,术中出血量为（104.62±57.69）和（136.89±57.92）ml,组间比较差异均有统计学意义（P〈0.05）;两组术后引流量、术后拔除引流管时间、术后住院时间和住院总费用分别为（65.59±76.95）和（83.78±76.38）ml、（2.78±1.18）和（3.43±1.66）d、（9.44±3.16）和（10.19±2.91）d、（20 954.31±1 745.10）和（20 635.65±1 376.92）元,组间比较差异均无统计学意义（P〉0.05）。术后两组发生并发症分别为2例和3例,经保守治疗均痊愈。术后随访2个月~2年,单侧无功能肾患者生活正常,肿瘤患者无复发和转移。结论 3D比2D高清腹腔镜技术在肾脏切除术中的应用立体感更强,解剖层次更清晰,准确性更好,降低手术的一定难度,更适合应用于高难度手术。

【Objective】To compare the application effect of 3D and 2D HD laparoscopy in the kidney resection.【Methods】32 cases of kidney resection were completed with the Storz 3D HD laparoscopic（Group Observation）.And the 37 finished cases were retrospectively analyzed and compared from January to December in 2013 with the help of Storz 2D HD laparoscopy（Group Comparison）. They were compared their operation time, bleeding volume,complications, postoperative drainage, postoperative drainage tube removal time, the hospitalization time, postoperative hospitalization expenses, and statistical analysis. 【Results】Both groups of operation cases were successfully finished. The amount of bleeding and the operation time in two groups respectively（124.41 ± 52.90） min and（149.00 ± 33.68） min,（104.62 ± 57.69） ml and（136.89 ± 57.92） ml. It was a significant difference between the two groups（P〈0.05）. Two groups of postoperative drainage, the drainage tube time, postoperative hospitalization time and total hospitalization expenses respectively were：（65.59 ± 76.95） ml and（83.78 ± 76.38） ml,（2.78 ± 1.18） d and（3.43 ± 1.66） d,（9.44 ± 3.16） d and（10.19 ± 2.91） d,（20954.31 ± 1745.10） yuan and（20635.65 ± 1376.92） yuan.There was no significant difference between groups（P〉0.05）. For two groups there were 2 cases and 3 cases of complications, they were cured after conservative treatment. The postoperative follow-up ranged from 2 months to 2years, there were no living unilateral renal function patients, without any recurrence and metastasis cases appeared to the cancer patients. 【Conclusions】It is stronger 3D than 2D HD laparoscopic nephrectomy in the intraoperative three-dimensional. There is clear anatomical level, and better accuracy. It reduces the difficulty of operation. It is more suitable for high difficulty operation.