后腹腔镜与经腰小切口肾部分切除术联合治疗T1期肾癌对患者肾功能影响研究

Study on the effect of retroperitoneal laparoscopic and small incision partial nephrectomy on renal function in patients with stage T1 renal cell carcinoma

目的 :探讨后腹腔镜小切口肾部分切除术对T1期肾癌的治疗效果及对患者肾功能的影响。方法 :回顾性分析2015年3月～2016年10月在我院接受手术治疗的肾癌患者的临床资料,根据其手术方式分为传统手术组和改良手术组,其中改良手术组采用后腹腔镜联合经腰小切口肾部分切除术。观察两组患者手术一般情况、术后炎症因子、肿瘤标志物和肾功能的差异。结果 :改良手术组患者的手术时间较传统手术组长,引流管留置时间较传统手术组短,两组患者手术出血量无差别;两组患者手术前炎症因子水平无差别,术后3天,改良手术组患者的IL-6、IL-10和CRP水平低于传统手术组;两组患者手术前肿瘤标志物水平无差别,术后3个月,改良手术组患者的CA50、CEA和CA125水平低于传统手术组;两组患者手术前肾功能比较无差别,术后3个月,改良手术组的BUN、SCr水平低于传统手术组,GFR水平高于传统手术组。结论 :后腹腔镜联合经腰小切口肾部分切除术对T1期肾癌有较好的治疗效果,可改善患者的康复情况和肾功能,有较好的应用价值。

Objective To investigate the effect of retroperitoneal laparoscopic combined with small incision and partial nephrectomy for renal cell carcinoma(T1) and its effect on renal function. Methods Retrospective analysis of clinical data of March 2015 to October 2016 year in our hospital accepted surgical treatment of patients with renal cell carcinoma, according to the operation mode is divided into traditional surgery group and modified group, the modified group used after laparoscopic lumbar small incision combined with partial nephrectomy. The general situation of the operation, inflammatory factors, tumor markers and renal function in the two groups were observed. Results The operation time of the improved operation group was shorter than that of the traditional operation group, the indwelling time of the drainage tube was shorter than that of the traditional operation group, and there was no difference between the two groups;No differences between the two groups of patients with operation of proinflammatory cytokines levels, 3 days after the operation, the modified group of patients with IL-6, IL-10 and CRP were lower than those of the traditional surgery group;There was no difference in the level of tumor markers before and after operation in the two groups. The CA50, CEA and CA125 levels of the patients in the modified operation group were lower than those of the traditional operation group at the end of the operation after the operation for 3 months;There was no significant difference in renal function before and after operation in the two groups. The BUN and SCr levels in the modified group were lower than those in the traditional operation group at the end of the operation, and the level of GFR was higher than that of the traditional operation group at the end of the 3 months after operation. Conclusion Retroperitoneal laparoscopic partial nephrectomy combined with small incision for the treatment of stage T1 renal cell carcinoma has a better therapeutic effect, can improve the recovery of patients and renal function, and has good application value.