手助后腹腔镜与标准后腹腔镜无功能积水肾切除术的比较

目的比较手助后腹腔镜与标准后腹腔镜切除无功能积水肾的效果与安全性。方法回顾分析手助后腹腔镜无功能积水肾切除36例（A组）及标准后腹腔镜无功能积水肾切除53例（B组）的临床资料，就两组手术时间、估计出血量、术后下床活动时间、术后住院天数、住院总天数、恢复工作时间、手术治疗费、总住院费以及并发症发生率等指标进行比较。结果A组在手术时间、术中出血量、手术治疗费、总住院费及淋巴漏发生率方面优于B组。而在术后下床活动时间、术后住院天数、恢复工作时间方面，两组没有明显差异。结论手助后腹腔镜切除无功能积水。肾保留了标准后腹腔镜创伤小，痛苦少，恢复快的优点，并能缩短手术时间，减少术中出血和术后并发症，降低花费，值得推广。

A comparison of hand-assisted nephrectomy and standard retro-laparoscopic nephrectomy for hydronephrosis

Objective To compare the effect and safety of hand-assisted nephreetomy and standard retro-laparoscopic nephreetomy for hydronephrosis. Methods The clinical data of 36 eases （group A） receiving hand-assisted retro-laparoseopie nephrectomy from January 2007 to November 2012 and 53 eases （group B） receiving standard retro-laparoseopic nephreetomy from January 2005 to November 2012 were retrospectively analyzed. Operative time, intraoperative bleeding, ambulation and normal activities after operation, the operation cost, total cost of hospitalization, the hospital stay and complications were compared. Results In group A, the operative time, intra-operative bleeding, operation cost, the total cost of hospitalization and the complications rate were superior to those in group B （P〈0.05）, while there was no difference in the ambulation after operation, the hospital stay and the resume of normal activities after operation. Conclusions Hand-assisted retro-laparoscopic nephrectomy for hydronephrosis offers minimal invasion, little pain and rapid recovery that are comparable to those of standard retro-laparoscopic nephrectomy. The benefits include shorter operating time, less blood loss, less complications and lower cost. Thus, this technique is worthy of popularization.