程序化解剖性后腹腔镜肾部分切除术治疗局限性肾癌的临床效果及预后观察

Clinical Effect and Prognosis of Programmed Anatomical Retroperitoneal Laparoscopic Partial Nephrectomy in the Treatment of Localized Renal Cell Carcinoma

目的 探讨程序化解剖性后腹腔镜肾部分切除术(RLPN)对局限性肾癌(LRCC)的治疗效果。方法 选取76例LRCC患者,按随机数字表法划分成两组,均为38例。对照组采取开放肾部分切除术(OPN),观察组则行RLPN,观察到术后3个月。对比两组手术相关指标、术后恢复情况、生活质量以及并发症。结果 观察组手术时间[(148.69±7.51)min]、肾脏热缺血时间[(24.59±2.36)min]长于对照组[(126.34±6.48)min、(19.31±1.67)min],术中出血量[(88.65±5.36)ml]少于对照组[(109.78±7.35)ml],胃肠功能恢复时间[(19.75±3.46)h]、引流管留置时间[(3.25±0.68)d]以及住院时间[(9.48±2.35)d]均短于对照组[(35.67±5.58)h、(5.16±1.24)d、(13.69±3.58)d],有统计学差异(P<0.05);术后3个月,观察组健康调查简表(SF-36)内各维度评分均高于对照组,有统计学差异(P<0.05);两组术后并发症发生率相当,无统计学差异(P>0.05)。结论 RLPN在LRCC治疗中虽手术时间与肾脏热缺血时间较长,但出血量更少,能够促进患者术后恢复,提高生活质量,且无严重并发症,利于患者预后,临床可大力推行。

Objective To investigate the therapeutic effect of programmed anatomical retroperitoneal laparoscopic partial nephrectomy(RLPN)on localized renal cell carcinoma(LRCC).Methods 76 patients with LRCC were selected and divided into 2 groups according to the method of random number table.The control group was treated with open partial nephrectomy(OPN),while the observation group was treated with RLPN,which was observed 3 months after operation.The operation related indexes,postoperative recovery,quality of life and complications were compared between the 2 groups.Results The operation time of the observation group[(148.69±7.51)min],the warm ischemia time of the kidney[(24.59±2.36)min]was longer than that of the control group[(126.34±6.48)min,(19.31±1.67)min],the intraoperative blood loss[(88.65±5.36)ml]was less than that of the control group[(109.78±7.35)ml],the recovery time of gastrointestinal function[(19.75±3.46)h]The indwelling time of the drainage tube[(3.25±0.68)d]and the hospitalization time[(9.48±2.35)d]were shorter than those of the control group[(35.67±5.58)h,(5.16±1.24)d,(13.69±3.58)d],with statistical difference(P<0.05);Three months after operation,the scores of each dimension in the observation group's health survey summary table(SF-36)were higher than those in the control group,with statistical difference(P<0.05);The incidence of postoperative complications in the 2 groups was similar,with no statistical difference(P>0.05).Conclusion RLPN in the treatment of LRCC,although the operation time and the warm ischemia time of kidney are longer,but the amount of bleeding is less,which can promote the postoperative recovery of patients,improve the quality of life,and have no serious complications,which is beneficial to the prognosis of patients.It can be vigorously promoted in clinical practice.