后腹腔镜肾部分切除术在小肾癌患者中的应用价值

Application value of retroperitoneal laparoscopic partial nephrectomy in patients with small renal cell carcinoma

目的后腹腔镜肾部分切除术在小肾癌患者中的应用价值。方法收集2018年2月~2021年1月贵州省人民医院收治的105例小肾癌患者的临床资料,根据治疗方式不同分为对照组(开放式肾部分切除术)48例和观察组(后腹腔镜肾部分切除术)57例。对比两组手术指标、住院时间及术后3个月肾功能、肌酐水平、生活质量、并发症、切缘阳性及复发/转移率。结果两组在手术时间、术中出血量、引流时间上比较差异无统计学意义(P>0.05),观察组患者住院时间短于对照组(P<0.05);治疗后3个月对照组eGFR水平低于术前和观察组(P<0.05),观察组手术前后eGFR水平差异无统计学意义(P>0.05);两组治疗后3个月肌酐水平均上升,但观察组低于对照组(P<0.05);治疗后,观察组功能领域、总体健康状况评分比对照组高,症状领域、单项项目低于对照组(P<0.05);治疗后观察组并发症总发生率低于对照组(P<0.05),两组均未出现切缘阳性及转移情况(P>0.05)。结论后腹腔镜肾部分切除术在小肾癌治疗中可行性高,对促进患者恢复,提高生活质量均有积极影响。

Objective To evaluate the clinical value of retrolaparoscopic partial nephrectomy in patients with small renal carcinoma.Methods The clinical data of 105 patients with small renal carcinoma admitted to our hospital from February 2018 to January 2021 were collected,and they were divided into control group(48 cases with open partial nephrectomy)and observation group(57 cases with retrolaparoscopic partial nephrectomy)according to different treatment methods.Operation indicators,length of hospital stay,renal function,creatinine level,quality of life,complications,positive margin and recurrence/metastasis rate 3 months after operation were compared between the two groups.Results There were no differences in operation time,intraoperative blood loss and drainage time between the two groups(P>0.05),and the hospitalization time in observation group was shorter than that in control group(P<0.05).3 months after treatment,the eGFR level in the control group was lower than that in the observation group(P<0.05),and there was no difference in the eGFR level before and after surgery in the observation group(P>0.05).Creatinine level in both groups increased 3 months after treatment,but the observation group was lower than the control group(P<0.05).After treatment,the scores of functional domains and overall health status in the observation group were higher than those in the control group,while the scores of symptom domains and individual items were lower than those in the control group(P<0.05).After treatment,the total incidence of complications in the observation group was lower than that in the control group(P<0.05),and no positive margin or metastasis occurred in the two groups(P>0.05).Conclusion Retroperitoneal laparoscopic partial nephrectomy is feasible in the treatment of small renal carcinoma,and has a positive effect on improving patients'recovery and quality of life.