后腹腔镜手术治疗肾肿瘤的临床疗效观察

Observation on the Clinical Effect of Retroperitoneal Laparoscopic Surgery in the Treatment of Renal Tumors

目的探究后腹腔镜与经腹腔行肾部分切除手术在肾肿瘤治疗中的临床疗效及预后。方法选择2017年8月—2019年11月于我院进行手术治疗的肾肿瘤患者90例,采用随机数字表法分为两组,各45例。研究组行后腹腔镜手术治疗,对照组采用经腹腔行肾部分切除术治疗。对比两组围术期指标及并发症发生率。结果研究组术中出血量为(111.72±9.84)mL、术后引流量为(250.45±39.13)mL,均少于对照组的(296.43±9.75)mL、(296.37±40.05)mL,术中热缺血时间为(19.02±2.21)min、术后置管时间为(2.91±0.89)d、住院时间为(8.59±1.20)d、胃肠道功能恢复时间为(1.84±0.33)h,均短于对照组的(26.98±2.14)min、(6.08±1.05)d、(13.51±1.39)d、(4.38±0.32)h,差异有统计学意义(P<0.05);研究组术后CRP水平为(9.11±1.80)mg/L、IL-6水平为(10.84±1.32)ng/L均低于对照组的(15.44±1.96)mg/L、(18.87±1.29)ng/L,差异有统计学意义(P<0.05);研究组并发症发生率为2.22%低于对照组的20.00%,差异有统计学意义(P<0.05)。结论与经腹腔行肾部分切除手术相比,采用后腹腔镜手术治疗肾肿瘤疗效确切,具有损伤小、术中出血量少、术后恢复快、并发症少等优势,利于促进预后恢复。

Objective To explore the clinical efficacy and prognosis of retroperitoneal laparoscopic and transabdominal partial nephrectomy in the treatment of renal tumors.Methods from August 2017 to November 2019,90 patients with renal tumor were selected and randomly divided into two groups,45 cases in each group.The study group received retroperitoneal laparoscopic surgery,while the control group received partial nephrectomy via abdominal cavity.The perioperative indexes and incidence of complications were compared between the two groups.Results The intraoperative blood loss and postoperative drainage volume of the study group were(111.72±9.84)mL and(250.45±39.13)mL,which were less than those of the control group(296.43±9.75)mL and(296.37±40.05)mL respectively.The intraoperative warm ischemia time was(19.02±2.21)min,the postoperative catheterization time was(2.91±0.89)d,the hospitalization time was(8.59±1.20)d,and the recovery time of gastrointestinal function was(1.84±0.33)h,which were shorter than those of the control group The difference was statistically significant(P<0.05);the postoperative CRP level and IL-6 level in the study group were(26.98±2.14)min,(6.08±1.05)d,(13.51±1.39)D and(4.38±0.32)H(P<0.05);the CRP level and IL-6 level in the study group were(9.11±1.80)mg/L and(10.84±1.32)ng/L in the study group,which were lower than those in the control group[(15.44±1.96)mg/L,(18.87±1.29)ng/L,the difference was statistically significant(P<0.05);the incidence of complications in the study group was statistically significant 2.22%,which was lower than 20.00%of the control group(P<0.05).Conclusion compared with transabdominal partial nephrectomy,retroperitoneal laparoscopic surgery is effective in the treatment of renal tumors,with advantages of less injury,less intraoperative blood loss,faster postoperative recovery and fewer complications,which is conducive to promoting the recovery of prognosis.