经后腹腔入路腹腔镜肾部分切除术治疗肾癌临床效果观察

Laparoscopic partial nephrectomy via retroperitoneal approach for the treatment of renal cell carcinoma:an analysis of its efficacy,related indicators and quality of life

目的观察经后腹腔入路腹腔镜肾部分切除术治疗肾癌的临床效果。方法选取遂宁市中心医院自2016年1月至2018年12月收治的120例肾癌患者为研究对象,将患者随机分入A组和B组,每组各60例。A组实施经腹入路腹腔镜肾部分切除术,B组实施经后腹腔入路腹腔镜肾部分切除术。比较两组患者近期疗效、围术期相关指标、术后疼痛评分和生活质量评分。结果 A组客观缓解率61.7%(37/60),疾病控制率91.7%(55/60);B组客观缓解率65.0%(39/60),疾病控制率93.3%(56/60)。两组患者客观缓解率、疾病控制率比较,差异均无统计学意义(P>0.05)。B组患者恢复进食时间为(3.25±0.78)h,短于A组的(4.18±0.91)h,差异有统计学意义(P<0.05);B组患者住院时间为(6.05±1.13)d,短于A组的(7.49±1.52)d,差异有统计学意义(P<0.05)。B组患者术后12、24、36、48 h疼痛评分分别为(3.46±0.97)分、(2.96±0.94)分、(2.57±0.85)分、(2.14±0.71)分,均低于A组的(4.52±1.18)分、(4.07±1.14)分、(3.68±1.11)分、(3.15±1.03)分,差异有统计学意义(P<0.05)。术后随访1个月,B组患者术后生理健康、心理健康、社会功能、总体感觉评分分别为(86.47±4.69)分、(85.86±4.21)分、(85.92±4.57)分、(86.07±4.73)分,均高于A组的(81.63±3.42)分、(81.05±3.10)分、(81.17±3.21)分、(81.12±3.35)分,差异有统计学意义(P<0.05)。结论经后腹腔入路腹腔镜肾部分切除术治疗肾癌近期疗效佳,可有效加快术后恢复,减轻疼痛感,改善生活质量。

Objective To investigate the effect of laparoscopic partial nephrectomy through retroperitoneal approach on the efficacy,related indicators and quality of life of renal carcinoma.Methods A total of 120 cases of patients received in our hospital with kidney cancer surgery were obtained in this study,and they were divided into two groups for prospective studies(60 cases in each group).Patients in Group A received laparoscopic partial nephrectomy via implementation of abdominal approach,and the others in Group B were operated by laparoscopic partial nephrectomy via implement the retroperitoneal approach.The near future curative effect,surgery,postoperative recovery time,postoperative pain score,cellular immune function indexes,the quality of life scores were compared between the two groups.Results There was no significant difference in objective response rate and disease control rate between the two groups(P>0.05).There were no statistically significant differences in the operative time and intraoperative blood loss between the two groups(P>0.05),but the postoperative feeding recovery time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).12,24 36 and 48 hours after surgery,the pain scores in the observation group were lower than those in the control group(P<0.05).After surgery,CD3+ and CD4/CD8 in both groups were lower than those before surgery(P<0.05),while all indexes in the observation group were higher than those in the control group(P<0.05).After 1 month of follow-up,the scores of quality of life in the observation group were higher than those in the control group(P<0.05).Conclusion Laparoscopic partial nephrectomy via retroperitoneal approach has a good short-term efficacy in patients with renal cancer,which can effectively accelerate postoperative recovery,reduce postoperative pain and impaired immune function,and improve postoperative quality of life.