后腹腔镜下与开放肾癌根治术临床疗效的回顾性比较

Retrospective comparison of retroperitoneal laparoscopy versus open approach to radical nephrectomy for renal cell carcinoma

目的回顾性比较后腹腔镜下肾癌根治术与开放肾癌根治术治疗肾癌的临床疗效。方法回顾性分析2012年8月至2015年3月收治的肾癌患者144例的临床资料，其中后腹腔镜手术68例（A组），传统的开放手术76例（B组）。对两组的临床疗效进行对比研究。结果两组发病年龄、体质量指数（BMI）、肿瘤大小、肿瘤位置的比较差异未见统计学意义（P〉0．05）；A组手术时间[（130．15±29．61）min]较B组手术时间[（116．88±26．18）min]长，二者比较差异有统计学意义（P〈0．05）。A组术中估计出血量为（154．12±80．47）ml，B组估计出血量为（213．42±138．86）ml，二者比较差异有统计学意义（P〈0．05）。A组术后肠功能恢复时间、术后拔除腹膜后引流管时间、术后下床活动时间、术后住院时间均明显优于B组，差异有统计学意义（P〈0．05）。A组并发症显著少于B组。结论后腹腔镜下肾癌根治术与开放式肾癌根治术相比，前者具有术中出血少、创伤小、恢复快、住院时间短等优点。所以后腹腔镜下肾癌根治术微创而有效。

Objective To compare the clinical effects of retroperitoneal laparoscopic radical nephrectomy and open approach to radical nephrectomy on renal cell carcinoma（RCC）. Methods From August 2012 to March 2015, the clinical data of 144 patients with RCC underwent radical nephrectomy were retrospectively analyzed. Sixty-eight patients in group A underwent retroperitoneoscopic radical nephrectomy, and 76 patients in group B underwent open radical nephrectomy for renal cell carcinoma. The clinical effects of the two groups were compared. Results There was no significant difference in age, BMI, tumor size or tumor location between the two groups（ P 〉 0.05 ）. The operation time of group A and group B was （ 130. 15 ± 29.61 ） min and （ 116. 88 ± 26. 18 ） min, there was significant difference （ P 〈 0. 05 ）. The intraoperative estimated blood loss in group A was （ 154. 12 ± 80. 47） ml, and （213.42 ± 138.86）ml in group B, there was significant difference（P 〈0. 05）. The intestinal function recovery time, the duration of retroperitoneal tube drainage, the ambulation time and postoperative hospital stay were shorter in group A than those in group B （P 〈 0. 05 ）. The complications in group A were less than those in group B. Conclusions Compared with open radical nephrectomy,retroperitoneal laparoscopic radical nephrectomy has the advantages of shorter operation period, lower blood loss, shorter hospital stay and earlier resumption of routine activities. So retroperitoneoscopic radical nephrectomy for renal carcinoma is a minimally invasive and effective procedure.