腹腔镜肾部分切除术与根治性切除术治疗T2a期肾癌比较研究及三年随访总结

目的 比较在我院治疗的T2a期肾癌行腹腔镜肾部分切除术及腹腔镜肾癌根治性切除术的临床疗效。方法 回顾性分析2014年6月至2017年6月在伊犁州友谊医院泌尿外科经腹腔镜手术治疗的108例T_2a期肾癌的临床资料，其中行腹腔镜肾部分切除术患者56例，行腹腔镜肾癌根治术者52例。比较两种手术方式临床指标。结果 两组手术时间、术中出血量、术中输血率、术后住院期并发症发生率、术后住院时间对比差异均无统计学意义(P均>0.05)；两组术后第3、6个月血肌酐相比较，差异均无统计学意义(P均>0.05)，腹腔镜肾部分切除术组术后第12个月及36个月血肌酐显著低于腹腔镜肾癌根治术组，相比较差异均有统计学意义(P均<0.05)。术后随访3年，其中腹腔镜肾部分切除术组复发率为7.14%，根治术组复发率为9.62%，两组相比较差异无统计学意义(P>0.05)。结论 与腹腔镜肾癌根治术相比较，肾部分切除术在治疗T_2a期肾癌时不增加手术时间、术中出血量、住院时间及手术并发症，同时能够充分地保护肾功能，在情况允许时可作为优先选择的手术方式。

Comparison of laparoscopic partial nephrectomy and laparoscopic radical nephrectomy in the treatment of stage T2a renal cell carcinoma

ObjectiveTo compare the clinical efficacy of laparoscopic partial nephrectomy (LPN) and laparoscopic radical nephrectomy (LRN) for T_2a stage renal cell carcinoma (RCC) in our hospital. MethodsThe clinical data of 108 patients with stage T_2a RCC treated by laparoscopic surgery in Urology department of Yili Friendship Hospital from June 2014 to June 2017 were retrospectively analyzed, including 56 patients with LPN and 52 patients with LRN. ResultsThere were no significant differences in operation time, intraoperative blood loss, intraoperative blood transfusion rate, incidence of postoperative complications, and postoperative hospital stay between the two groups (P>0.05). There was no significant difference in serum creatinine between the two groups in the third and sixth month after operation (P>0.05). The serum creatinine of LPN group was significantly lower than that of LRN group in the twelfth and thirty-sixth month after operation, and the differences were statistically significant (P<0.05). The recurrence rate of LPN group was 7.14%, and LRN 9.62%. There was no significant difference between the two groups (P>0.05). ConclusionCompared with LRN, LPN does not increase the operation time, intraoperative blood loss, hospital stay and surgical complications in the treatment of stage T_2a renal cancer, and can protect the renal function. It can be used as the preferred surgical method when the situation permits.