后腹腔镜根治性肾切除术治疗左、右侧肾癌的疗效和技巧分析

Therapeutic effect and skill analysis of retroperitoneal laparoscopic radical nephrectomy

目的:分析总结后腹腔镜根治性肾切除术治疗左右侧肾癌的临床疗效及手术技巧。方法:选取行后腹腔镜根治性肾切除术患者51例,左侧26例,右侧25例;比较两组患者手术时间、术中出血量、术后胃肠功能恢复时间、引流管拔除时间、术后住院天数、术后主要并发症发生情况。结果:两组患者在手术时间、术中出血量、术后胃肠功能恢复时间、引流管拔除时间、术后住院天数等方面均无显著差异(P>0.05)。两组患者均未出现术后出血、切口感染、深静脉血栓等严重并发症。结论:后腹腔镜根治性肾切除术对局限性肾癌的治疗安全、有效,且创伤较小,值得临床推广,但在左右侧肾蒂的处理上有所区别,需要术者熟悉解剖结构及标志。

Objective The aim of this study was to analyze and summarize the therapeutic effect and skill of retroperitoneoscopic radical nephrectomy for the treatment of left and right renal cell carcinoma.Method A total of 51 patients who had undergone retroperitoneoscopic radical nephrectomy were included in this study, 26 cases on the left side and 25 cases on the right side.The operation time, the bleeding during operation, the recovery time of gastrointestinal function after operation, the time of drainage tube extraction, postoperative hospital stay, and the major complications after surgery was compared between two groups.Results There was no significant difference between the two groups in the operation time, the bleeding during operation, the recovery time of gastrointestinal function after operation, the time of drainage tube extraction and postoperative hospital stay(P>0.05).No serious complication such as postoperative bleeding, incision infection or deep vein thrombosis was occurred in the two groups.Conclusion Retroperitoneoscopic radical nephrectomy is safe and effective for the treatment of localized renal cell carcinoma, and it is worthy of clinical promotion.However, the treatment of the left and right renal pedicles is different.It is necessary for the operators to be familiar with the anatomical structure and marker.