腹腔镜肾癌根治术与开放性肾癌根治术治疗局限性肾癌的效果比较

Comparison on the Effects of Laparoscopic Radical Nephrectomy and Open Radical Nephrectomy for the Treatment of Localized Renal Carcinoma

目的比较腹腔镜肾癌根治术与开放性肾癌根治术治疗局限性肾癌患者的临床效果。方法回顾性分析我院2014年12月至2017年12月收治的50例局限性肾癌患者,依据患者手术方案的不同分成两组,其中27例采用腹腔镜肾癌根治术治疗的患者为腹腔镜组,23例采用开放性肾癌根治术治疗的患者为开放组。比较两组患者的临床疗效、并发症发生率、手术时间、术中出血量、胃肠功能恢复时间与住院时间。结果腹腔镜组的总有效率为96.30%,开放组为82.61%,差异无统计学意义(P>0.05)。腹腔镜组的并发症发生率为3.70%,显著低于开放组的26.09%,差异具有统计学意义(P<0.05)。腹腔镜组的手术时间、术中出血量、胃肠功能恢复时间及住院时间均显著优于开放组,差异具有统计学意义(P<0.05)。结论对于局限性肾癌患者,采取开放性与腹腔镜肾癌根治术均可取得较好的临床效果,但腹腔镜肾癌根治术患者的并发症发生率更低,术中出血量更少,手术时间、胃肠功能恢复时间以及住院时间更短,更利于患者术后恢复。

Objective To compare the clinical effects of laparoscopic radical nephrectomy and open radical nephrectomy for the treatment of patients with localized renal carcinoma. Methods 50 cases of patients with localized renal carcinoma admitted to our hospital from December 2014 to December 2017 were retrospectively analyzed. All cases were divided into two groups according to the surgical plans. 27 cases of the laparoscopic group were treated with laparoscopic radical nephrectomy, and 23 cases of the open group were treated with open radical nephrectomy. The clinical therapeutic effect, incidence of complications, surgical time, amount of intraoperative blood loss, recovery time of gastrointestinal function and hospitalization time were compared between the two groups. Results The total effective rate was 96.30% of the laparoscopic group, and 82.61% of the open group, with no statistically significant difference （P 〉0.05）. The incidence of complications of the laparoscopic group was 3.70%, significantly lower than 26.09% of the open group, with statistical difference （P 〈0.05）. The surgical time, amount of intraoperative blood loss, recovery time of gastrointestinal function and hospitalization time of the laparoscopic group were significantly better than those of the open group, with statistical differences （all P〈0.05）. Conclusions For patients with localized renal carcinoma, both open and laparoscopic radical nephrectomy may achieve a good clinical outcome, but laparoscopic radical nephrectomy has lower incidence of complications, less amount of intraoperative blood loss, and shorter surgical time, recovery time of gastrointestinal function and hospitalization time, which is more conducive to the patients＇ postoperative recovery.