单切口肾输尿管全切除术治疗中下段输尿管癌与双切口同种手术的比较

Comparison of single-incision total nephreterectomy for middle-lower ureteral carcinoma and double-incision operation

目的本研究总结89例实施单切口与双切口肾输尿管切除术的中下段输尿管癌患者的临床资料,探讨传统开放手术两种切口对手术过程及术后恢复的影响。方法回顾性分析2013年6月至2018年12月中国医科大学附属盛京医院泌尿外科收治的行肾输尿管全切除术的中下段输尿管癌患者的临床资料,根据手术切口不同分为单切口组(A组)及双切口组(B组),记录两组手术方式的手术时间、术中出血量、胃肠功能恢复时间、拔除腹腔引流管时间,拔除盆腔引流管时间、术后住院天数等。结果单切口组(A组)在手术时间、术中出血量、腹腔引流管拔除时间、术后住院时间方面优于传统双切口组(B组)(P <0.05),在胃肠功能恢复时间、盆腔引流管拔除时间及术后转移复发方面差异无统计学意义(P>0.05)。结论单切口行肾输尿管切除术较双切口同种术式具有手术入路简单,术中不需变化体位,手术步骤少,过程简单等优势,是开放手术方式治疗上尿路上皮癌理想的手术方法。

Objective Compare the differences of Single-incision and double-incision nephroureterectomy with bladder-cuff resection for the middle and lower part of ureteral cancer.Methods Through A retrospective study of 89 patients undergoing nephroureterectomy with bladder-cuff resectionfor middle and lower part of ureteral cancer,and according to the operation,it can be divided into two groups,respectively,the single incision surgical group(group A)and double incision surgical group(group B),to compare two groups of patients with the basicstandard like gender,side,age of two groups of patients.At the same time,to compare the operation time,blood loss,postoperative gastrointestinal function recovery time,hospitalization days and other indicators of progressive comparison.Results The operative time,blood loss,postoperative peritoneal drainage tube pulled out time,postoperative hospital stay time of A group are better than B group,the difference was statistically significant;pelvic drainage tube pulled out time and postoperative gastrointestinal function recovery time aresame with statistics analysis.Conclusion Single incision group with shorter operation time,little injury and pain,rapid recovery,and it is a better choice for the hospitals which have no condition to do the laparoscopic treatment for middle and lower part of ureteral cancer.