经尿道电凝联合后腹腔镜下肾输尿管切除术对尿路上皮癌患者近期预后影响研究

Effect of transurethral electric coagulation combined retroperitoneal laparoscopic nephroureterectomy on short - term prognoses in patients with upper urinary tract urothelial carcinoma

目的探讨研究经尿道电凝联合后腹腔镜下肾输尿管切除术对尿路上皮癌患者近期预后的影响。方法随机选取本院泌尿外科于2010年1月至2013年8月收治的尿路上皮癌患者80例，按照就诊序列号的先后顺序平均分为研究组和对照组。研究组患者采用经尿道电凝联合后腹腔镜下肾输尿管切除术方式进行治疗，对照组患者采用经尿道电切联合后腹腔镜下肾输尿管切除术方式进行治疗。对比两组各项手术指标、术后并发症情况以及术后各时期肿瘤复发率。结果研究组的手术时间和术中出血量与对照组相比较，差异无统计学意义（P〉0．05），而前者术后住院时间和治疗费用较后者显著减少（P〈0．01）；研究组术后并发症发生率（2．5％）较对照组（20．0％）显著降低（P〈0．05）；研究组术后3个月、术后6个月、术后1年肿瘤复发率差异均无显著统计学意义（P〉0．05），术后2年研究组肿瘤复发率（5．0％）较对照组（25．0％）显著降低（P〈0．05）。结论采用经尿道电凝联合后腹腔镜下肾输尿管切除术对尿路上皮癌患者进行治疗效果显著，术后并发症发生率低，且预后效果好。

Objectives To explore the effect of transurethral electric coagulation combined retroperitoneal laparoscopic nephroureterectomy on short -term prognoses in patients with upper urinary tract urothelial carcinoma. Methods 80 cases of patients with upper urinary tract urothelial carcinoma were randomly selected in our hospital from January 2010 to August 2013, which according to the order of the serial number of patients were divided into study group and control group. The patients in the study group were treated by transurethral electric coagulation combined with retroperitoneal laparoscopic nephroureterectomy. The patients in the control group were treated by transurethral elctric resection combined with retroperitoneal laparoscopic nephroureterectomy. The postoperative complications and the recurrence rates of tumor after operation were compared between the two groups. Results There were no significant differences between the operation time and the amount of blood loss in two groups （ P 〉 0.05 ） , but the hospitalization time and treatment cost of the former were significantly lower than those of the latter（ P 〈 0.01）. The incidence of postoperative complications （2.5%） in the study group was significandy lower than that in the control group （20%, P = 0. 034）. There were no significant differences in the recurrence rates of the study group after 3, 6 months and 1 year（ P 〉0.05） ,but after 2 years the recurrence rate of the study group （ 5.0% ） was significantly lower than that in the eontrol group （25.0%, P 〈 0.05 ）. Conclusions The efficacy of transurethral electric coagulation combined with retroperitoneal laparoscopic nephroureterectomy is remarkable.with low incidence rate of Dostoperative complications.