后腹腔镜肾部分切除术治疗肾肿瘤的安全性研究

目的 研究后腹腔镜肾部分切除术(RLPN)治疗肾肿瘤的围手术期情况及临床效果.方法 回顾性总结2007年7月至2011年3月期间我们进行的肾肿瘤肾部分切除手术,其中RLPN 45例,开放性肾部分切除术(OPN)28例,对两组的手术时间、血管阻断时间、术前及术后肾功能变化情况、术中出血量、术后引流量等围手术期指标进行比较分析.结果 两组术前术后肾功能变化、患肾肾小球滤过率(GFR)变化情况均没有明显差别,RLPN组在血管阻断及手术时间上稍长于OPN组,其他多个统计项目均明显优于OPN组.术中创面缝合止血方法的改进可简化手术操作,提高止血效果,缩短肾血管阻断时间.结论 后腹腔镜肾部分切除术具有较高的安全性,与开放性手术相比较微创优势明显,具有良好的临床效果,是治疗早期肾肿瘤比较安全可靠的手术方式.

The assessment of the safety in retroperitoneal laparoscopic partial nephrectomy for renal tumor

Objective To evaluate the perioperative condition and clinical effects of renal tumors treated by retroper- itoneal laparoscopic partial nephrectomy （RLPN）. Methods From July 2007 to March 2011, 28 eases of OPN and 45 eases of RLPN were performed for 7 cm or smaUer tumors in a solitary functioning kidney. The data were analyzed retro- spectively, including time of surgery and vessel occlusion, estimated blood loss, preoperative and postoperative sCr and GFR, indicators for convalescence and so on. Results There were no significant differences neither in the sCr nor GFR between two groups. RLPN group showed longer time of vessel occlusion and surgery, but was superior in other statistical variables to the OPN group. The improvement of suture and no-knot-sew could simplify surgical procedures, enhancing he- mostasis and reducing renal vessel occlusion. Conclusion RLPN is comparably safe as OPN, and has obvious advantage in minimally invasive surgery with well clinical effects, RLPN would be a preferred surgery treatment for early kidney tumor in a safe and reliable way.