后腹腔镜肾部分切除术与开放手术治疗局限性肾癌的疗效比效

Comparison of clinical effects between retroperitoneal laparoscopic and open partial nephrectomy for localized renal carcinoma

目的比较后腹腔镜肾部分切除术(RLPN)与开放肾部分切除术(PN)治疗局限性肾癌的疗效与安全性。方法选取行肾部分切除术的局限性肾癌患者共98例,其中52例行后腹腔镜肾部分切除术,另外46例行开放肾部分切除术,观察比较两组患者的一般资料、术中及术后各项参数,并对患者进行随访,观察效果。结果RLPN组患者术中出血量、术后肠道功能恢复时间、术后住院天数均少于或短于PN组(P﹤0.05);两组患者手术时间、术中肾热缺血时间及术后血肌酐(Cr)、血红蛋白(Hb)变化幅度比较,差异均无统计学意义(P﹥0.05)。结论后腹腔镜肾部分切除术治疗局限性肾癌与开放肾部分切除术比较疗效相当,手术创伤小,患者术后恢复更快,随着手术技巧的提高,可能逐渐取代开放手术。

Objective To compare the safety and efficacy between retroperitoneal laparoscopic partial nephrectomy（RLPN） and open partial nephrectomy（PN） for localized renal carcinoma. Method A retrospective analysis was performed in 98 patients with renal carcinoma who were treated with nephron-sparing surgery. Among those patients, 52 were treated with retroperitoneal laparoscopic partial nephrectomy and 46 were administered with open partial nephrectomy. The characteristics of patients, intra-and post-operative measures of the two groups were collected and compared,all patients were followed to evaluate the efficacy. Result The RLPN group had less intraoperative blood loss, shorter postoperative gastrointestinal recovery time, and shorter hospital stay than PN group（P〈0.05）; and there were no significant difference in operative time, warm ischemia time and the changes in serum creatinine level and hemoglobin between the two groups（P〈0.05）. Conclusion Retroperitoneal laparoscopic partial nephrectomy is as effective and safe as open surgery in the treatment of patients with renal carcinoma, and is less invasive, with faster postoperative recovery. With the improvement of surgical skills, it will be a better alternative treatment as compared with open procedure.