后腹腔镜下与开放性肾癌根治术治疗局限性肾癌的临床疗效及安全性分析

Clinical efficacy and safety of retroperitoneal laparoscopic and open radical nephrectomy in the treatment of localized renal cell carcinoma

目的:评估后腹腔镜下肾癌根治术(RLRN)与开放性肾癌根治术(ORN)对局限性肾癌(LRCC)患者的临床疗效及安全性。方法:将2019年2月—2022年2月的96例LRCC患者,按照随机方式分为观察组(48例,行RLRN)和对照组(48例,行ORN),对比两组血清学指标、T淋巴细胞亚群、肾功能指标、手术相关指标、疼痛程度和术后并发症。结果:手术前,两组血清学指标、T淋巴细胞亚群、肾功能指标比较差异无统计学意义(P>0.05);术后,观察组血清学指标、T淋巴细胞亚群水平优于对照组(P<0.05),但两组间肾功能指标比较差异无统计学意义(P>0.05);观察组手术相关指标(术中失血量、手术用时、住院天数、肠胃功能恢复时间)优于对照组(P<0.05),手术费用高于对照组(P<0.05);与对照组比较,观察组轻度疼痛率更高,重度疼痛率、术后并发症发生率更低(P<0.05)。结论:对LRCC患者实施RLRN,应激反应小,有利于免疫功能恢复,减轻疼痛感,减少并发症,缩短康复进程。

Objective:To evaluate the clinical efficacy and safety of retroperitoneal laparoscopic radical nephrectomy(RLRN)and open radical nephrectomy(ORN)in patients with localized renal cell carcinoma(LRCC).Methods:All 96 patients with LRCC from February 2019 to February 2022 were randomly assigned to the observation group(48 cases were included in RLRN)and the control group(48 cases were included in ORN).The serological indexes,tlymphocyte subsets,renal function indexes,operation related indexes,degree of pain and postoperative complications were evaluated.Results:There was no significant difference in serum indexes,tlymphocyte subsets and renal function indexes between the groups before operation(P>0.05).A after operation,the serological indexes and tlymphocyte subsets in the observation group were better(P<0.05),but there was no significant difference in renal function indexes between the groups(P>0.05).Compared with the control group,the operation related indexes(intraoperative blood loss,operation time,hospital stay,gastrointestinal function recovery time)in the observation group were better,but the operation cost was more(P<0.05).Compared with the control group,the observation group had higher rate of mild pain,lower rate of severe pain and lower incidence of postoperative complications(P<0.05).Conclusion:The implementation of RLRN in patients with LRCC has small stress response,which is conducive to restoring immune function,reducing pain,reducing complications and shortening the rehabilitation process.