后腹腔镜下无肾蒂血管阻断肾部分切除术治疗低度复杂性肾肿瘤

Retroperitoneal laparoscopic partial nephrectomy without blockage of renal pedicle for the treatment of uncomplex renal tumor

目的 探讨后腹腔镜下无肾蒂血管阻断肾部分切除术治疗肾低度复杂性肿瘤的疗效、价值及意义.方法 回顾性分析后腹腔镜下无肾蒂血管阻断肾部分切除术治疗的低度复杂性肾肿瘤患者10例（观察组）的临床资料,并与后腹腔镜下阻断肾蒂血管肾部分切除术的患者10例（对照组）进行对照分析,比较两组术中出血量、手术时间、术后平均引流管放置时间、术后住院时间,观察两组手术前后血红蛋白（Hb）、血清肌酐（Ccr）和肾小球滤过率（GFR）的变化.结果 观察组手术时间、术中出血量、术后引流管放置时间、术后住院时间分别为（103.0 ±42.7）min、（100.0±70.4） mL、（3.5±1.2）d、（5.0±1.2）d,对照组分别为（129.2±57.5） min、（89.2±9.5）mL、（6.5±9.7）d、（6.3±3.4）d,两组差异均有统计学意义（t=4.23、3.23、1.57、4.24,均P＜0.05）.术前,两组Hb、Ccr、GFR差异均无统计学意义（均P＞0.05）;术后,对照组Hb、Ccr、GFR分别为（85.7±18.2） g/L、（77.9±22.1）μmol/L、（61.4±50.9）mL· min-1·1.73（m2）-1,观察组分别为（95.6±13.5）g/L、（70.2±10.5） μmol/L、（85.5±5.1）mL·min-1·1.73（m2）-1,两组差异均有统计学意义（t =9.34、7.44、7.34,均P＜0.05）.结论 后腹腔镜下行不阻断肾蒂血管的肾部分切除术是治疗低度复杂性肾肿瘤安全有效的方法,具有操作简便的优点,并有利于患者肾功能的恢复.

Objective To evaluate the efficacy and clinical significance of partial laparoscopic resection of renal pedicle without renal pedicle vascular resection in the treatment of low renal complex tumors.Methods Retrospective analysis of retroperitoneal laparoscopic renal artery clamping without partial nephrectomy in the treatment of the patients with low-grade complex renal tumors in 10 cases（observation group） and the clinical data of retroperitoneal laparoscopic renal pedicle occlusion of renal vascular resection in 10 patients （control group） were analyzed.The amount of bleeding,operation time,the average hospitalization time,drainage tube placement after operation,the hemoglobin （Hb）,serum creatinine（Ccr） and glomerular filtration rate（GFR） changes were observed in the two groups.Results The operation time,bleeding volume,postoperative drainage tube placed time,postoperative hospitalization time of the observation group were （103.0 ± 42.7） min,（100.0 ± 70.4） mL,（3.5 ± 1.2） d,（5.0 ± 1.2） d,respectively,which of the control group were （129.2 ± 57.5） min,（89.2 ± 9.5） mL,（6.5 ± 9.7） d,（6.3 ± 3.4） d,respectively,there were statistically significant differences between the two groups （t =4.23,3.23,1.57,4.24,all P ＜0.05）.Before operation,the Hb,Ccr and GFR between the two groups had no statistically significant differences（all P ＜0.05）.After operation,the Hb,Ccr and GFR of the control group were （85.7 ± 18.2） g/L,（77.9 ± 22.1） μmol/L,（61.4 ± 50.9） mL · min-1 · 1.73 （m2）-1,respectively,which of the observation group were （95.6 ± 13.5） g/L,（70.2 ± 10.5） μmol/L,（85.5 ± 5.1） mL · min-1 · 1.73 （m2）-1,respectively,there were statistically significant differences between the two groups（t =9.34,7.44,7.34,all P ＜0.05）.Conclusion Retroperitoneal laparoscopic renal partial nephrectomy without blocking renal pedicle vessels is a safe and effective method for the treatment of low complexity renal tumors.It has advantages of simple operation and is beneficial to the recovery of patients＇function.