基于层面解剖技术的单一体位完全腹腔镜下肾盂输尿管癌根治术治疗上尿路肿瘤的效果评价

Evaluation of Effect of Single Position Complete Laparoscopic Radical Resection of Pyeloureteral Carcinoma Based on Sectional Anatomy Technique for Upper Urinary Tract Tumors

目的:探究基于层面解剖技术的单一体位完全腹腔镜下肾盂输尿管癌根治术治疗上尿路肿瘤的效果。方法:回顾性分析2021年6月—2022年6月于新余市人民医院治疗的70例上尿路肿瘤患者的临床资料,按手术体位不同将其分为研究组(n=32,行基于层面解剖技术的单一体位完全腹腔镜下肾盂输尿管癌根治术)与对照组(n=38,行传统腹腔镜下肾盂输尿管癌根治术)。比较两组手术相关指标、疼痛情况、应激指标、并发症发生情况及预后情况。结果:研究组肠道功能恢复时间、下床活动时间、拔除引流管时间均早于对照组,住院时间、手术时间均短于对照组,视觉模拟评分法(VAS)评分低于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。术后,两组超氧化物歧化酶(SOD)均比术前低,丙二醛(MDA)均比术前高,但研究组SOD高于对照组,MDA低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组肿瘤复发率比较,差异无统计学意义(P>0.05)。结论:基于层面解剖技术的单一体位完全腹腔镜下肾盂输尿管癌根治术治疗上尿路肿瘤的效果确切,可减少术中出血,缩短患者住院时间,降低并发症发生率,促进术后恢复。

Objective:To explore the effect of single position complete laparoscopic radical resection of pyeloureteral carcinoma based on sectional anatomy technique for upper urinary tract tumors.Method:The clinical data of 70 patients with upper urinary tract tumors treated in Xinyu People's Hospital from June 2021 to June 2022 were retrospectively analyzed.According to different surgical positions,they were divided into the study group(n=32,treated with single position complete laparoscopic radical resection of pyeloureteral carcinoma based on sectional anatomy technique)and the control group(n=38,treated with traditional laparoscopic radical resection of pyeloureteral carcinoma).The indexes of operation,pain,stress,complications and prognosis were compared between the two groups.Result:The intestinal function recovery time,getting out of bed time,drainage tube removal time of the study group were earlier than those of the control group,hospitalization time and operation time were shorter than those in control group,the visual analogue scale(VAS)score was lower than that of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant(P<0.05).After operation,superoxide dismutase(SOD)were lower and malondialdehyde(MDA)were higher in both groups than those before operation,but SOD in the study group was higher than that in the control group,MDA was lower than that in the control group,the differences were statistically significant(P<0.05).The complication rate of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:The single position complete laparoscopic radical resection of pyeloureteral carcinoma based on sectional anatomy technique is effective in the treatment of upper urinary tract tumors,which can reduce intraoperative bleeding,shorten the length of hospital stay,reduce the incidence of complications,and promote postoperative recovery.