经腹入路和腹膜后入路腹腔镜下肾部分切除术疗效比较

目的 比较经腹腹腔镜肾部分切除术与腹膜后腹腔镜下肾部分切除术的疗效.方法 回顾性分析2013年9月至2014年9月施行的63例行腹腔镜下肾部分切除术患者,其中33例行经腹腹腔镜手术,30例行腹膜后腹腔镜手术.应用采用t检验或x2检验对两组患者手术时间、术中出血量、术中阻断时间、血肌酐变化、术后并发症发生率、术后拔管时间、术后住院时间、术后拆线时间等进行分析比较.结果 腹腔镜组与开发组相比,术中出血量(31.82±14.71)和(27±12.52)mL,P＞0.05]、术中阻断时间(26.09 ±6.83)和(31.40±2.32)min,P＞0.05]、术后并发症发生率(8.57％)和(16.67％),P＞0.05]、术后血肌酐变化值(14.55±4.14)和(9.06±2.86) μmol/L,P＞0.05]、术后恢复饮食时间(3.0±0.45)和(2.4±0.52)d,P＞0.05]、术后住院天数(5.27±1.42)和(4.9±1.73)d,P＞0.05]差异均无统计学意义;而手术时间(89.91±24.46)和(114.4 ±31.54) min,P＜0.05]经腹组小于经腰手术组,术后拔管时间(7.33±2.06)和(12.18 ±2.71)d,P＜0.05]经腰组小于经腹手术组.结论 与经腰手术相比,经腹腹腔镜手术组可以获得相同的疗效,并且能够一定程度降低手术时间,是一种安全有效的手术方式.

Clinical comparison of retroperitoneal and transperitoneal approach of laparoscopic partial nephrectomy

Objectives To evaluate and compare the efficiency of transperitoneal and retroperitoneal approach of laparoscopic partial nephrectomy.Methods A retrospective analysis of 63 patients who underwent laparoscopic partial nephrectomy,including 33 patients underwent transperitoneal laparoscopic surgery and 30 patients underwent retroperitoneal laparoscopic surgery in our hospital from September 2013 to September 2014 were performed.The operation time,intraoperative blood loss,warm ischemia time,blood Scr concentration,complications,removal time of drainage tube,hospital stays,wound healing time were collected and compared between the two groups.Results Transperitoneal group vs.retroperitoneal group,hemorrhage volume (31.82 ± 14.71)vs.(27 ± 12.52) mL,P ＞ 0.05],warm ischemia time (26.09 ± 6.83) vs.(31.40 ± 2.32) min,P ＞ 0.05],rates of complications (8.57％) vs.(16.67％),P ＞ 0.05],blood Scr concentration (14.55 ± 4.14) vs.(9.06 ±2.86) μmoL/L,P ＞0.05],recovery eating time (3.0 ±0.45) vs.(2.4 ±0.52)d,P＞0.05],and hospital stays (5.27 ± 1.42) vs.(4.9 ± 1.73) d,P ＞ 0.05] have no statistics differences.But operation time (89.91 ± 21.46) vs.(114.4 ± 31.54) min,P ＜ 0.05] in transperitoneal group was significantly reduced while removal time of drainage tube was a little longer(7.33 ± 2.06)vs.(12.18 ±2.71)d,P ＜0.05] compared with retroperitoneal group.Conclusions Compared with retroperitoneal approach,transperitoneal approach could achieve the same efficacy,and have the advantage of reduction of operation time,it is an efficiency and safety surgical method.