后腹腔镜肾根治性切除术中肾标本取出方法的探索

Exploration of the method of renal specimen extraction in retroperitoneal laparoscopic radical nephrectomy

目的探讨一次性切口保护套在后腹腔镜肾根治性切除术中的应用及标本取出效率。方法回顾性分析本院2018年12月至2019年6月接受后腹腔镜肾根治性切除术的37例肾癌患者的临床资料。根据手术后标本取出体外的方法分为观察组(18例)和对照组(19例),观察组使用一次性切口保护套,对照组则使用传统自制标本袋;观察比较两组患者标本的取出时间和置入次数等指标。结果观察组与对照组的标本取出时间分别为(225.94±47.04)、(508.84±45.81)s,差异有统计学意义(P<0.05)。观察组中有17例患者标本一次性顺利取出,1例因肿瘤较大,取出困难,经延长切口后顺利取出,所有标本完整均未破裂;对照组中有17例患者标本一次性顺利取出,另外2例患者经适当延长切口后取出,所有标本完整均未破裂。两组置入次数比较,差异无统计学意义(P>0.05)。术后随访1年发现,所有患者均未出现癌细胞经手术切口种植转移的情况。结论在后腹腔镜肾根治性切除术中运用一次性切口保护套来辅助取标本,其手术时间短、操作简单,易上手,具有实用价值,值得临床推广应用。

Objective To explore the application of disposable surgical protective sleeve in retroperitoneal laparoscopic radical nephrectomy.Methods The clinical data of 37 patients with renal cancer who received retrolaparoscopic radical nephrectomy in our hospital from December 2018 to June 2019 were retrospectively analyzed.According to the method of taking out the specimens after surgery,they were divided into observation group(18 cases)and control group(19 cases).The observation group was treated with disposable incision protective sleeve,and the control group was treated with traditional self-made specimen bag.The time of specimen removal and the times of implantation were observed and compared between the two groups.Results The extraction time of the observation group and the control group was(225.94±47.04)s and(508.84±45.81)s,respectively,and the difference was statistically significant(P<0.05).In the observation group,17 patients'specimens were successfully removed once,and 1 patient was successfully removed after extended incision due to large tumor,and all specimens were intact without rupture.In the control group,17 patients were successfully removed once,and the other 2 patients were removed after appropriate extension of incision,and all specimens were intact without rupture.There was no significant difference in the number of implantation between the two groups(P>0.05).The postoperative follow-up for 1 year showed that no cancer cells were transferred through surgical incision implantation in all patients.Conclusions In the retroperitoneal laparoscopic radical nephrectomy,surgical protective sleeve is used to assist the collection of specimens,which is of practical value due to its short time and simple operation,and is worthy of clinical popularization and application.