不同入路方法下腹腔镜手术治疗肾癌的效果及对肾功能、预后的影响

Effects of laparoscopic surgery under different approaches in the treatment of renal carcinoma and its influence on renal function and prognosis

目的探究不同入路方法下腹腔镜手术治疗肾癌的效果及对肾功能、预后的影响。方法选取2017年1月至2019年5月就诊于本院的100例肾癌患者,根据选择的手术方式不同分为对照组(47例),行经腹腔入路腹腔镜肾癌根治术;试验组(53例),行经腹膜后入路腹腔镜肾癌根治术。比较两组手术效果、并发症、肾功能、预后等情况。结果试验组手术时间、引流量及住院时间均少于对照组(均P<0.05),两组术中出血量及引流管拔除时间差异均无统计学意义(均P>0.05)。对照组并发症发生率为8.51%(4/47),试验组为5.66%(3/53)(P>0.05)。术后两组患者肾功能均下降但比较无统计学差异(P>0.05);1年内对照组远处转移1例,无复发,1年内试验组远处转移2例,复发1例,两组比较差异均无统计学意义(均P>0.05)。结论两种入路腹腔镜下肾癌根治术均可有效治疗肾癌,但经腹膜后入路方式可缩短手术时间及住院时间,减少术后引流量,临床价值更高。

Objective To explore the effects of laparoscopic surgery under different approaches in the treatment of renal carcinoma and its influence on renal function and prognosis.Methods A total of 100 patients with renal carcinoma treated in our hospital from January 2017 to May 2019 were selected and were divided into control group(47 cases,laparoscopic radical nephrectomy via abdominal approach)and experimental group(53 cases,laparoscopic radical nephrectomy via retroperitoneal approach)according to the different surgical methods.Surgical effects,complications,renal function,and prognosis were compared between the two groups.Results The surgical time,drainage volume,and hospital stay in the experimental group were all less than those in the control group(all P<0.05),there were no statistically significant differences in intraoperative blood loss and drainage tube removal time between the two groups(both P>0.05).The incidence of complications was 8.51%(4/47)in the control group and 5.66%(3/53)in the experimental group(P>0.05).The renal function in the two groups both decreased after the surgery,but there was no statistically significant difference between the two groups(P>0.05).Within a year,there was 1 case of distant metastasis and no recurrence in the control group,there were 2 cases of distant metastasis and 1 case of recurrence in the experimental group(both P>0.05).Conclusion Laparoscopic radical nephrectomy under two approaches are effective in the treatment of renal carcinoma,but laparoscopic radical nephrectomy via retroperitoneal approach can shorten the surgical time and hospital stay,and reduce postoperative drainage volume,with higher clinical value.