后腹腔镜肾癌根治性切除术与后腹腔镜肾癌肾部分切除术治疗肾癌的效果及对患者肾功能的影响分析

目的对比在后腹腔镜辅助治疗下的肾癌患者应用根治性切除术与肾部分切除术治疗的效果以及对肾功能的影响。方法100例接受后腹腔镜辅助治疗的肾癌患者,按照随机数字表法分为对照组(52例)和试验组(48例)。对照组患者采用根治性切除术,试验组患者采用肾部分切除术。对比两组手术时间、术中出血量、术后住院天数及术后3个月、6个月、1年的血肌酐水平。结果两组患者的住院天数比较差异无统计学意义(P>0.05);试验组患者的术中出血量(98.55±10.44)ml少于对照组的(199.38±29.32)ml,手术时间(162.19±6.03)min长于对照组的(138.02±5.54)min,差异具有统计学意义(P<0.05)。术后3、6个月,两组患者的血肌酐水平比较差异无统计学意义(P>0.05);术后1年,试验组患者的血肌酐(83.67±6.99)μmol/L显著低于对照组的(95.34±7.63)μmol/L,差异具有统计学意义(P<0.05)。结论在后腹腔镜辅助治疗下的肾癌患者应用根治性切除术与肾部分切除术治疗疗效基本相当,但肾部分切除术能对肾功能进行更好的保留,故应根据患者的实际情况选择相应的术式,以肾部分切除术为优先考虑手术。

Analysis of the effects of retroperitoneoscopic radical nephrectomy and retroperitoneal partial nephrectomy for renal carcinoma and their influence on renal function of patients

Objective To compare the effects of retroperitoneoscopic radical nephrectomy and retroperitoneal partial nephrectomy for renal cancer and their influence on renal function of patients.Methods A total of 100 patients with renal carcinoma who received retroperitoneoscopic adjuvant therapy were divided into control group(52 cases)and experimental group(48 cases)according to random numerical table.The control group was treated with radical nephrectomy,and the experimental group was treated with partial nephrectomy.The operation time,intraoperative blood loss,postoperative hospitalization time,and blood creatinine levels at 3 months,6 months,and 1 year after operation were compared between the two groups.Results There was no statistically significant difference in hospitalization time between the two groups(P>0.05).The intraoperative blood loss(98.55±10.44)ml of the experimental group was less than(199.38±29.32)ml of the control group,and operation time(162.19±6.03)min was longer than(138.02±5.54)min of the control group,and the difference was statistically significant(P<0.05).At 3 and 6 months after operation,there was no statistically significant difference in blood creatinine levels between the two groups(P>0.05).1 year after operation,the blood creatinine levels(83.67±6.99)μmol/L of the experimental group was significantly lower than(95.34±7.63)μmol/L of the control group,and the difference was statistically significant(P<0.05).Conclusion Both retroperitoneoscopic radical nephrectomy and retroperitoneal partial nephrectomy show equal effect on renal carcinoma,but partial nephrectomy can better preserve the renal function.Therefore,the appropriate surgical method should be selected according to the actual situation of the patient,and partial resection is the priority.