经腹腔与经后腹腔途径行腹腔镜上尿路尿路上皮癌根治性切除术的疗效比较

Comparison of efficacy between transperitoneal and retroperitoneal laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma

目的：探讨经腹腔途径行腹腔镜上尿路尿路上皮癌根治术的安全行、可行性及优势。方法：收集2012年10月~2014年11月收治的上尿路尿路上皮癌患者29例,随机分成两组,A组14例,采用后腹腔途径行腹腔镜上尿路尿路上皮癌根治性切除术;B组15例,行不改变患者体位的经腹腔途径行完全腹腔镜肾输尿管及膀胱袖状切除术。观察两组的手术时间及患者术后恢复情况。结果：A组手术时间（198±20）min,B组手术时间（145±24）min,两组手术时间差异有统计学意义（P〈0.05）;术中出血、术后康复时间、随访时间及肿瘤复发情况,两组差异无统计学意义（P〉0.05）。结论：不改变患者体位的经腹腔途径更节省手术时间,其完全腹腔镜肾输尿管及膀胱袖状切除治疗上尿路尿路上皮癌是安全可行的。

Objective：To discuss the feasibility and advantages of transperitoneal laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma（UUT-UC）.Method：We collected the clinical data of 29 patients with UUT-UC from October 2012 to November 2014,and divided these 29 cases into two groups randomly.Fourteen patients（group A）with upper urinary tract tumors underwent retroperitoneal laparoscopic nephroureterectomy,while other 15 patients（group B）received bladder cuff excision and distal ureterectomy by transperitoneal laparoscopic approach without changing the patient＇s position.We observed operation time and postoperative recovery of patients of two groups.Result：The operating time was（198±20）min for group A and（145±24）min for group B,which showed significant difference between two groups（P〈0.05）.However,there wasn＇t significant difference in blood loss,postoperative recovery time,follow-up period and tumor recurrence between two groups（P〉0.05）.Conclusions：Transperitoneal laparoscopic nephroureterectomy without changing patient＇s position is an effective and time-saving way for UUT-UC.