后腹腔镜根治性肾癌切除术与传统开放手术的比较  

Comparison of laparoscopic retroperitoneal radical nephrectomy and open radical nephrectomy

作　　者：朱方强[1] 江军[1] 靳凤烁[1] 王洛夫[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所泌尿外科,重庆400042

出　　处：《第三军医大学学报》2006年第13期1427-1429,共3页Journal of Third Military Medical University

摘　　要：目的 与传统开放手术比较，评价后腹腔镜肾癌根治术的手术方法及临床效果。方法 回顾性分析和比较43例后腹腔镜肾癌根治术（A组）和50例同期开放性肾癌根治术（B组）的临床资料，比较术中出血量、手术时间及术后恢复情况。患者均行B超、IVP、CT或MRI检查术前明确诊断。采用后腹腔镜手术行肾癌根治43例，同期50例行开放手术患者作为对照组。A组患者肿瘤大小2．0—8．5em，平均5．2em。B组患者肿瘤大小3．0—10．2em，平均5．7cm。两组术前临床分期均为：T1N0M0-T3aN0M0。结果A、B两组手术时间分别为：（156±35）min和（137±53）min（P〉0．05），A、B两组手术失血量分别为（132±75）ml和（412±110）ml（P〈0．01），A、B两组术后镇静剂用量分别为（20±10）mg和（120±20）mg，（P〈0．01），A、B两组术后下床活动时间分别为（28±12）h和（72±16）h（P〈0．01），A、B两组术后住院时间分别为（5．5±1．4）d和（13．7±3．3）d（P〈0．05），A、B两组术后恢复正常活动时间分别为（14．3±3．1）d和（23．9±6．5）d（P〈0．01）。结论后腹腔镜肾癌根治术较开放手术在减少术中出血，加快术后恢复方面具有明显优势，可达到同样根治的效果。Objective To evaluate the operation method and clinical value of laparoscopic retroperitoneal radical nephrectomy as compared with open surgery. Methods The clinical data of 43 cases （group A） with renal neoplasm receiving laparoscopic retroperitoneal radical nephrectomy and 50 cases （group B） with renal neoplasm receiving open radical nephrectomy were retrospectively analyzed. The size of renal neoplasms was 2. 0 - 8.5 cm （ average 5.2 cm） in group A, 3.0 - 10.2 cm （ average 5.7 cm） in group B, respectively. The preoperative clinical stage was T1N0M0 to T3aN0M0. All patients were made a definite diagnosis by B ultrasonic inspection, IVP, CT and MRI. The operation time, bleeding volume during the operation, hospital stay, postoperative pain degree, the recovery of ambulation and normal activities were compared between group A and group B. Results In group A, beside the operation time （ P 〉 0. 05 ）, bleeding volume during operation, hospital stay, postoperative pain degree, the recovery of normal activities were all better than those in group B （ P 〈 0. 05 or P 〈 0.01 ）. Conclusion The laparoscopic retroperitoneal radical nephrectomy, compared with the classical open radical nephrectomy, has the advantages of less pain and rapid recovery, and can decrease the complications remarkably. It may be a better therapeutic method for kidney cancer.

关 键 词：肾肿瘤 后腹腔镜 肾切除术 

分 类 号：R572[医药卫生—消化系统] R699.2[医药卫生—内科学]