后腹膜腔镜根治性肾癌切除术与开放手术的疗效比较

目的 比较后腹膜腔镜根治性肾癌切除术与开放根治性肾癌切除手术的临床疗效.方法 回顾性分析90例经术后病理确诊的T1-2N0M0肾癌患者分别行后腹膜腔镜根治性肾切除术（后腹膜腔镜组）32例与开放根治性肾癌切除术（开放手术组）58例的临床资料,对比分析两种手术方法在手术时间、术中出血量、术后禁食时间、术后引流管留置时间、术后住院时间、并发症等方面的差异.结果 两组手术均获成功,后腹腔镜组平均手术时间为（86±17） min,术中出血量为（80±28） ml,术后禁食时间（28±7） h,术后引流管留置时间（2.8±1.4） d,术后住院时间（7.3±3.6） d,30例随访3-18个月,无复发及远处转移,死于脑血管疾病1例;开放手术组平均手术时间为（76±32） min,术中出血量为（140±57） ml,术后禁食时间（39±11） h,术后引流管留置时间（3.7±1.1） d,术后住院时间（9.3±2.8） d,51例随访3-24个月,无复发及远处转移,死于心、脑血管疾病3例.结论 与开放根治性肾癌切除术相比,后腹腔镜肾癌根治术具有出血少、住院时间短、恢复快等优点.

Comparing efficacy of laparoscopic retroperitoneal radical nephrectomy and open radical nephrectomy

Objective To compare the efficacy of the retroperitoneal laparoscopic radical nephrectomy and open radical nephrectomy surgical therapy renal cell carcinoma. Methods A retrospective study was conducted between April 2008 and April 2010. 90 cases confirmed T1 - 2NOM0 renal cell carcinoma after pathologically, 32 cases treated by retroperitoneal laparoscopic radical nephrectomy （retroperitoneal laparoscopic group）, 58 cases treated by open radical nephrectomy （open group） ）and compared the clinical data ineluding operative time, blood loss, postoperative fasting time, postoperative drainage tube indwelling time, postoperative hospital stay and complications were analyzed. Results The operation was successful in two groups, and in the laparoscopic group, mean operative time was （ 86 ± 17 ） min, blood loss was （80 ± 28 ） ml, postoperative fasting time was （28 ± 7） h, after drainage tube indwelling time was （ 2.8 ± 1.4） d, postoperative hospital stay was （7.3± 3.6） d, 30 patients were followed up 3 - 18 months, There was no recurrence and distant metastasis, one case died of cerebral vascular disease ; in open surgery group, the average operation time was （76 ± 32）min, blood loss was （ 140 ± 57 ） ml, postoperative fasting time was （ 39 ± 11 ） h, postoperative drainage tube indwelling time was （3.7 ± 1.1 ） d, postoperative hospital stay was （9.3 ± 2.8 ） d, 51 patients were followed up 3 - 24 months, there was no recurrence and distant metastasis, 3 cases died of heart and cerebrovascular disease. Conelus｜on Comparing with open radical nephrectomy, the laparoscopic radical nephrectomy is less bleeding, shorter hospital stay and rapid recovery.