开放肾癌根治术与腹腔镜肾癌根治术的临床效果比较

目的比较常规开放肾癌根治术及腹腔镜下肾癌根治术的疗效及安全性。方法回顾性分析湖北省孝感市中心医院院2010年3月～2012年5月腹腔镜肾癌根治术患者55例（腹腔镜组）和开放肾癌根治术患者30例（开放手术组）的临床资料，比较两组手术切口长度、手术时间、术中出血量、术后开始进食时间、术后下床活动时间、术后拔除引流管时间、术后住院天数及并发症发生率的差异。结果腹腔镜组在手术切口长度[（8．8±2．6）、（15．1±1．3）cm]、术中出血量[（52．2±15．3）、（195．1±28．6）mL]、术后开始进食时间[（33±11）、（69±15）h]、术后下床后动时间[（31±13）、（74±17）h]、术后拔除引流管时间[（2．2±0．7）、（4．1±1．2）d]、术后住院天数[（5．4±1．2）、（9．0±1．8）d1、术后并发症发生率（3．64％、16．7％）等方面均优于开放手术组患者，差异均有统计学意义（均P〈0．05）；而在手术时间方面[（103.3±16．9）、（120．4±18．4）min]差异无统计学意义（P〉0．05）。结论腹腔镜肾癌根治术安全有效、恢复快、并发症少等优点，较开放根治。肾癌切除术具有较大优势。

Comparative efficacy analysis of laparoscopic radical nephrectomy and open radical nephrectomy for renal cell carcinoma

Objective To evaluate the clinical effect and safety of laparoscopic radical nephrectomy and open radical nephrectomy for renal cell carcinoma. Methods 55 cases of laparoscopic radical nephrectomy （laparoscopy group） and 30 cases of open radical nephrectom （open surgery group） from March 2010 to May 2012 in Central Hospital in Xiaogan City were retrospectively analyzed. Difference between two groups on incision length, operative time, blood loss, start eating time after surgery, postoperative ambulation time, postoperative drainage tubes removed time, postoperative hospital days and complications were compared. Results Incision length [（8.8 ±2.6） cm], blood loss [（52.2±15.3） mL], start eating time after surgery [（33±11） hi, postoperative ambulation time [（31±13） hi, postoperative drainage tubes removed time [（2.2±0.7） d], postoperative hospital days [（5.4±1.2） d] and complication rate （3.64%） in laparoseopy group were all better than those in open surgery group [（15.1±1.3）cm, （195.1±28.6） mL, （69±15） h, （74± 17） h, （4.1±1.2） d, （9.0±1.8） d, 16.7%], the differences were all statistically significant （all P 〈 0.05）; the difference of operative time in the two groups [（103.3±16.9） vs （120.4±18.4） mini was not statistically significant （P 〉 0.05）. Conclusion Laparoscopic radical nephrectomy has the advantages of less blood loss, faster recovery, and fewer complications than open radical nephrectomy, it has wide preponderance.