后腹腔镜下肾部分切除术治疗肾肿瘤的疗效及安全性分析

目的 探讨后腹腔镜下肾部分切除术治疗肾肿瘤的疗效及安全性。方法 收集2013年1月至2015年1月收治的肾脏肿瘤患者36例，按手术方法将患者分为观察组（n=18）和对照组（n=18）。观察组行后腹腔镜下肾部分切除术， 对照组行开放性肾部分切除术。比较两组手术效果、并发症情况以及肿瘤复发情况。结果 全部患者均顺利完成手术。观察组和对照组的手术时间分别为（108.7±42.7）min和（133.5±53.3）min，差异无统计学意义（P=0.135）。观察组和对照组的术中出血量分别为（122.8±37.4）ml和（231.7±58.2）ml，热缺血时间分别为（29.3±2.7）min和（15.4±3.2）min，术后住院时间分别为（8.7±1.3）d和（14.4±2.0）d，术后进食时间分别为（44.3±18.2）h和（73.8±15.1）h，差异均有统计学意义（P＜0.001）。两组围术期各有4例发生并发症。随访18个月，均无复发病例。结论 后腹腔镜下肾部分切除术可达到与常规开放手术相近的疗效，且患者术后恢复更快。

Efficacy and safety of retroperitoneal laparoscopic partial nephrectomy in the treatment of renal tumors

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic partial nephrectomy in the treatment of renal tumor.Methods From January 2013 to January 2015,36 patients with renal tumors were enrolled.The patients were divided into observation group (n =18) and control group(n =18) based on operative approaches.In observation group,18 cases received retroperitoneal laparoscopic partial nephrectomy,and control group received open partial nephrectomy.The effect of operation,complications and recurrence of tumors were compared between the two groups.Results All patients were conducted successfully.The operating time of obervation group and control group was (108.7 ± 42.7) min and (133.5 ± 53.3) min (P =0.135).The amount of bleeding in observation group and control group was (122.8±37.4)ml and (231.7±58.2)ml,the warm ischemia time was (29.3± 2.7)min and (15.4±3.2) min,postoperative hospitalization time was (8.7± 1.3)d and (14.4±2.0)d,and postoperative food-taking time was (44.3± 18.2) h and (73.8± 15.1) h.The differences between the two groups had statistically significance (P＜0.001).Four cases of complications were found in each group during perioperative period.No recurrence was found during 18 months' follow-up period in the two groups.Conclusion Retroperitoneal laparoscopic partial nephrectomy can achieve the same effect as the conventional open surgery,and the patients recover quicker after operation.