腹腔镜下肾癌根治术(腹膜后路径)技术改进的临床研究

Modified techniques and clinical research of retroperitoneal laparoscopic radical nephrectomy

目的探讨腹腔镜肾癌根治术(腹膜后路径)技术改进的手术经验和临床效果。方法选取本院2015年9月至2017年12月右肾肾癌患者50例,根据手术方式分为传统手术组和技术改进组,比较两组患者术中出血量、手术时间、术后进食时间和术后住院天数。结果后腹腔镜肾癌根治术经过技术改进,手术时间(106.0±17.4)min、术中出血量(117.0±23.2)ml、术后住院时间(5.5±1.0)d,均低于对照组(均P<0.05);术后肠功能恢复时间与对照组相比差异无统计学意义[(31.0±5.1)h比(35.0±9.3)h,P>0.05]。术中及术后均未发生明显并发症,随访1年未见肿瘤复发及穿刺通道的种植性转移。结论与传统的后腹腔镜根治性肾切除术相比,改进的后腹腔镜肾癌根治术具有手术时间短、出血少、住院天数少等优点。

Objective To investigate the surgical experience and clinical effect of modified retroperitoneal laparoscopic radical nephrectomy. Methods The clinical data of 50 cases undergoing retroperitoneal laparoscopic radical nephrectomy were retrospectively analyzed and summarized. According to the surgical methods, the patients were divided into a traditional operation group and a technical improvement group. The intraoperative bleeding volume, operation time, postoperative feeding time, and postoperative hospital stay were compared. Results After the technique of retroperitoneal laparoscopic radical nephrectomy modified, the operation time was (106±17.40) min, the intraoperative bleeding volume was (117.0±23.2) ml, and the postoperative hospital stay was (5.5±1.0) in the observation group, which were lower than those in the control group (all P < 0.05). The intestinal function recovery time was (31.0±5.1) h in the observation group and was (35.0±9.3) h in the control group (P > 0.05). No obvious complications occurred during and after operation. No recurrence of tumor and implanted metastasis of the puncture channel were observed in one year follow-up. Conclusion Compared with the traditional laparoscopic radical nephrectomy, the improved retroperitoneal laparoscopic radical nephrectomy shows the advantages of short operation time, less bleeding, and fewer days of hospitalization.