后腹腔镜下与开放式两种肾细胞癌根治术的临床疗效分析

目的比较后腹腔镜下与开放式两种肾细胞癌根治术的术中术后疗效。方法行后腹腔镜肾癌根治术35例(A组),开放肾癌根治术40例(B组),比较AB两组的手术时间、术中失血量、术后肠功能恢复时间、术后引流时间、术后下床活动时间、术后镇痛剂使用、住院时间和手术效果的差别。结果 A、B两组手术时间分别为:(150±31)min和(139±33)min(P0.05),两组手术失血量分别为(135±73)ml和(421±108)ml(P0.01),两组术后肠功能恢复时间分别为(30±14.1)h和(60±19.4)h(P0.01),两组术后引流时间分别为(26.8±5)d和(72±6.5)d(P0.01),两组术后镇静剂用量分别为(30±10)mg和(130±20)mg,(P0.01),两组术后下床活动时间分别为(27±4)h和(73±15)h(P0.01),两组术后住院时间分别为(6±1.5)d和(13±2.5)d(P0.01)。结论后腹腔镜肾细胞癌根治术比开放手术在减少术中出血,加快术后恢复方面更有优势,T1N0M0～T2N0M0肿瘤手术可达到同样根治的效果。

Comparison of laparoscopic retroperitoneal radical nephrectomy and open radical nephrectomy

Objective To evaluate the operation method and clinical value of laparoscopic retroperitoneal radical nephrectomy as com- pared with open surgery. Methods The clinical data of 35 cases （ group A ） with renal neoplasm receiving laparoscopic retroperitoneal radical nephrectomy and 40 cases（ group B）with renal neoplasm receiving open radical nephrectomy were retrospectively analyzed. Resuits The operation time was （ 150 ± 31 ） min in group A, （ 139 ± 33 ） min in group B, respectively; The blood loss was （ 135 ± 73 ） ml in group A, （ 421 ± 108 ） ml in group B, respectively ; The time of recovery of intestinal function after operation in group A was （ 30 ± 14.1 ） h, （60 ± 19.4 ） h in group B, respectively ; Amount time of postoperative drainage was （ 26.8 ± 5 ） d in group A, （ 72 ± 6.5 ） d in group B, re- spectively;The dose of analgesic was （30 ±10 ）mg in group A, （130 ± 20 ）mg in group B, respectively;The time to ambulation was （27 ± 4） h in group A, （ 73 ± 15 ） h in group B, respectively ; The hospital stay in group A was （ 6 ± 1.5 ） d, and （ 13 ± 2.5 ） d in group B, respec- tively. Conclusion The laparoseopie retroperitoneal radical nephrectomy, compared with the classical open radical nephrectomy, has the advantages of less pain and rapid recovery, and can decrease the complications remarkably ,while providing equally effective cancer con- trol for patients with T1NOM0 or T2NOM0 tumor.