3D腹腔镜与2D腹腔镜在肾部分切除术中的应用效果比较

Comparison on clinical effects between 3D laparoscopy and 2D laparoscopy in partial nephrectomy

目的比较3D腹腔镜与2D腹腔镜下肾部分切除术的临床疗效。方法回顾性分析洛阳市中心医院2015年2月至2017年3月行腹腔镜下肾部分切除术的53例患者的临床资料。其中行3D腹腔镜22例（3D组），行2D腹腔镜31例（2D组）。分析比较两组手术时间、术中出血量、肾动脉阻断热缺血时间、术后引流天数、术后肠道恢复时间、术后住院天数、住院费用。结果两组手术均顺利完成，无中转开腹者。3D组手术时间与肾脏热缺血时间少于2D组（P〈0．05）；两组术中出血量、术后引流天数、术后肠道恢复时间、术后住院天数、住院费用比较差异均未见统计学意义（P均〉0．05）。术后随访6～48个月，未出现局部肿瘤复发、远处转移或肾功能不全。结论与2D腹腔镜相比，3D腹腔镜下肾部分切除术能够缩短手术时间和肾动脉阻断热缺血时间，降低了手术难度，是一项值得推广的技术。

Objective To compare the efficacy of 3-dimensional （3D） laparoscopy and 2-di- mensional （2D） traditional laparoscopy in partial nephrectomy （PN）. Methods Clinical data of 53 pa- tients who were treated by laparoscopie PN in Luoyang Central Hospital from February 2015 to March 2017 were retrospectively analyzed, of which 22 cases （3D group） underwent 3D laparoscopic PN and 31 cases （2D group） underwent 2D laparoscopic PN. The operation time, intraoperative bleeding volume, reanl warm isehemia time, the drainage tube time, postoperative intestinal recovery time, postoperative hospitalization time and total hospitalization expenses between the two groups were compared. Results All 53 cases of operation were conducted successfully, without converting to open surgery. Compared with 2D group, the 3D group had significantly shorter operation time and renal warm isehemia time （P 〈 0.05 ） ; there was no significant difference in intraoperative bleeding volume, the drainage tube time, postoperative hospitalization time and total hospitalization expenses between the two groups （P all 〉 0. 05）. During a followed-up of 6 to 48 months, there was no recurrence, metastasis or renal in- sufficiency in the two promotion. Conclusions Compared with traditional 2D laparoscopy surgery, 3D laparoscopic PN can readuce operative difficulty, shorten operation time and renal warm isehemia time, which is worthy of clinic promotion.