后腹腔镜下与开放性肾癌根治术治疗局限性肾癌疗效比较

Comparison of the clinical effect of retroperitoneal laparoscopic and open radial nephrectomy for localized renal cell carcinoma

目的比较后腹腔镜下与开放性肾癌根治术治疗局限性肾癌的临床疗效。方法回顾性分析广汉市人民医院泌尿外科于2013年1月至2016年12月期间收治的63例局限性肾癌患者的临床资料,根据手术方式的不同分别纳入后腹腔镜组(n=31)与开放组(n=32),比较两组患者的围手术期相关指标。结果后腹腔镜组患者的手术时间、肠功能恢复时间及住院时间分别为(75.93±14.12)min、(2.24±0.79)d、(10.19±2.36)d,均短于开放组的(89.58±15.93)min、(3.15±1.01)d、(13.58±3.41)d,术中出血量为(103.62±25.85)m L,少于开放组的(153.55±36.76)m L,差异均有统计学意义(P<0.05);后腹腔镜组患者的并发症发生率为9.68%,明显低于开放组的28.13%,差异有统计学意义(P<0.05)。结论后腹腔镜肾癌根治术与传统的开放性肾癌根治术相比,具有创伤小、手术并发症发生率低及术后恢复快的优势。

Objective To compare the clinical effect of retroperitoneal laparoscopic and open radial nephrecto-my for localized renal cell carcinoma. Methods The clinical data of 63 patients with localized radial nephrectomy in Department of Urology in Guanghan People＆#39;s Hospital from January 2013 to December 2016 were retrospectively ana-lyzed. The patients were assigned to receive retroperitoneal laparoscopic radial nephrectomy group （retroperitoneal lapa-roscopic group, n=31） and open radial nephrectomy group （open group, n=32）. The perioperative related indexes of the two groups were compared. Results The operative time, intestinal function recovery time and hospitalization time in retroperitoneal laparoscopic group were （75.93±14.12） min, （2.24±0.79） d, （10.19±2.36） d, which was significantly short-er than （89.58 ± 15.93） min, （3.15 ± 1.01） d, （13.58 ± 3.41） d in the open group. The blood loss was （103.62 ± 25.85） mL, which was significantly less than （153.55±36.76） mL in open group, P〈0.05. The complication rate of the retroperitoneal laparoscopic group was 9.68%, which was significantly lower than 28.13%of open group, P〈0.05. Conclusion Com-pared with traditional open radical nephrectomy, retroperitoneal laparoscopic radical nephrectomy has the advantages of less trauma, less complications and faster postoperative recovery.