后腹腔镜下保留肾单位手术与肾根治切除术治疗早期肾癌的临床效果对比

Comparison of Clinical Effect between Retroperitoneal Laparoscopic Nephron-sparing Surgery and Radical Nephrectomy in the Treatment of Early-stage Renal Cancer

目的:探讨后腹腔镜下保留肾单位手术和根治性肾切除术治疗早期肾癌的效果。方法:回顾性选取2020年4月-2021年11月厦门大学附属中山医院收治的86例早期肾癌患者,按照治疗方法的不同将其分为对照组和观察组,每组43例。对照组进行后腹腔镜下根治性肾切除术,观察组进行后腹腔镜下保留肾单位手术,对比两组的治疗效果,包括手术相关指标情况、血肌酐水平(术前和术后3、6个月)、并发症发生率及术后6个月生活质量评分。结果:观察组手术时间长于对照组,住院时间短于对照组(P<0.05),术中出血量、术后引流量均少于对照组(P<0.05)。术后3、6个月观察组Scr水平均低于对照组(P<0.05)。观察组出现感染、出血、腰部疼痛、血肿的总发生率为6.98%,低于对照组的23.26%(P<0.05)。术后6个月观察组SF-36量表各维度评分均高于对照组(P<0.05)。结论:后腹腔镜下保留肾单位手术治疗早期肾癌的效果优于根治性肾切除术,可有效减少术中出血量、术后引流量,缩短住院时间,改善血肌酐水平,且可减少并发症发生率,提高患者生活质量,值得于临床治疗中推广。

Objective:To investigate the effect of retroperitoneal laparoscopic nephron-sparing surgery and radical nephrectomy in the treatment of early-stage renal cancer.Method:A total of 86 patients with early-stage renal cancer admitted to Zhongshan Hospital Affiliated to Xiamen University from April 2020 to November 2021 were retrospectively selected,according to different treatment methods,they were divided into control group and observation group,with 43 cases in each group.The control group underwent retroperitoneal laparoscopic radical nephrectomy,and the observation group underwent retroperitoneal laparoscopic nephron-sparing surgery.The treatment effects of the two groups were compared,including the surgery related indicators,serum creatinine level (before and 3 and 6 months after the surgery),complication rate and quality of life score at 6 months after the surgery.Result:The surgery time of the observation group was longer than that of the control group,the hospitalization time was shorter than that of the control group (P<0.05),the intraoperative blood loss and postoperative drainage volume were less than those of the control group (P<0.05);the Scr level in the observation group were lower than those in the control group at 3 and 6 months after surgery (P<0.05).The total incidence of infection,bleeding,waist pain and hematoma in the observation group was 6.98%,lower than 23.26% in the control group (P<0.05).Six months after surgery,the scores of SF-36 in the observation group were higher than those in the control group (P<0.05).Conclusion:Retroperitoneal laparoscopic nephron-sparing surgery is superior to radical nephrectomy in the treatment of early renal cell carcinoma,it can effectively reduce intraoperative blood loss,postoperative drainage,and shorten hospital stay,improve the serum creatinine level,reduce the incidence of complications,and improve the quality of life of patients.It is worthy of promotion in clinical treatment.