后腹腔镜根治性肾切除术与开放手术治疗局限性肾癌的疗效比较

目的比较后腹腔镜根治性肾切除术与开放手术治疗局限性肾癌的临床效果。方法回顾性分析我院2006年1月～2009年1月行后腹腔镜根治性。肾切除术（后腹腔镜组）42例与开放根治性肾切除术（开放手术组）45例的临床资料，比较两种手术方法在手术时间、术中出血量、术后肠道恢复时间、术后住院时间、并发症等方面的差异。结果两组手术均获成功。后腹腔镜组的术中出血量、术后肠道恢复时间、术后住院时间等均明显少于开放手术组（P〈0．05），而手术时间两组差异无统计学意义。两组均无严重并发症发生，开放手术组2例输血。术后随访3～26个月，平均9个月，后腹腔镜组1例发生肝转移死亡，开放手术组2例出现远处转移而死亡。结论与开放手术相比，后腹腔镜根治性肾切除术具有创伤小、术后恢复快、并发症少等优点，是治疗T1～2 N0M0局限性肾癌患者的一种安全、有效的方法。

A comparative study of retroperitoneal laparoscopic and open radical nephrectomy for localized renal carcinoma

Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic radical nephrectomy for localized renal carcinoma as compared with open surgery. Methods The clinical data of 42 patients receiving retroperitoneal laparoscopic radical nephrectomy （retroperitoneal group） and 45 patients receiving open radical nephrectomy （open group） from January 2006 to January 2009 were retrospectively analyzed. The operation time, blood loss, time of recovery of bowel function, postoperative hospital stay, and occurrence of complications of the two groups were compared. Results The two groups of procedure were successfully completed. In retroperitoneal group, the blood loss, the time of recovery of bowel function, and the postoperative hospital stay were better than those in open group, but there was no significant difference in operation time between the two groups. There was no serious complications occurred in the two groups, and two cases needed blood transfusion in open group. All patients were followed up for 3-26 months （mean, 9 months）, one patient in retroperitoneal group died of liver metastasis, and two cases in open group died of distant metastasis after operation. Conclusions As compared to open radical nephrectomy, retroperitoneal laparoscopic nephrectomy has the advantages of mini-invasion and rapid recovery, and is the safe and effective method of treatment for patients with T1-2 N0 M0 renal carcinoma.