后腹腔镜与开放式肾癌根治术的临床疗效比较  

Compare the clinical efficacy of retroperitoneal laparoscopic versus open radical nephrectomy

作　　者：庞松强[1] 范治璐[2] 孙卫兵[2] 杨玻[2] 刘志宇[2] 

机构地区：[1]北京市顺义区医院泌尿外科,101300 [2]大连医科大学附属第二医院泌尿外科,116027

出　　处：《中国医师进修杂志》2008年第3期4-6,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较后腹腔镜与开放式肾癌根治术的临床疗效。方法2003年10月至2006年10月，对临床分期为T1N0M0或T2N0M0期90例患者，施行后腹腔镜肾癌根治术49例（A组），开放式肾癌根治术41例（B组），对两组的临床疗效进行回顾性分析。结果A组46例手术成功。4例（8．7％）出现主要并发症，随访（21．9±6．1）个月。B组手术均成功，1例因术后脑出血死亡。9例（22．5％）出现主要并发症，随访（24．9±7．8）个月。病理、证实均为肾恶性肿瘤。两组病例在肿瘤大小、手术时间、随访时间比较差异无统计学意义（P〉0.05），而术中出血量、术后引流时间、术后下床活动时间、肠功能恢复时间、术后住院时间、术后镇痛剂使用、输血等方面比较，差异有统计学意义（P〈0．01）。结论与开放式肾癌根治术相比，后腹腔镜肾癌根治术具有微创、痛苦小、恢复快、并发症少等优点，而对T1N0M0或T2N0M0期肿瘤控制，临床疗效相同。Objective To evaluate the clinical efficacy and comphcation rate by open or retroperitoneal laparoscopic radical nephrectomy for renal tumor with stages T1N0M0 or T2N0M0. Methods Between October 2003 and October 2006,90 patients with renal cell carcinoma, which were clinically localized stages T1N0M0 or T2N0M0. Based on the patients＇ options to undergo retroperitoneal laparoscopic radical nephrectomy （group A,49 patients） and open radical nephrectomy （group B,41 patients）. The clinical efficacy were compared between group A and group B,retrospectively. Results In group A, the operations of 46 patients were successful,4 cases occurred major complications （8.7%） during the follow-up visit which lasted for （21.9 ±6.1 ）months. The operations in group B were all successful,9 cases occurred major complications （22.5%） during the follow-up visit which lasted for （ 24.9 ± 7.8 ）months. All cases were renal malignant tumors with pathologically confirmed stages T1N0M0 or T2N0M0 and there were no renal pedical lymph node metastasis. The age,weight,body mass index （BMI）,tumor size,operating time and the time of follow-up were no statistically significant differences between the two groups（P 〉 0.05 ） ,while the blood loss,amount of postoperative drainage, time to ambulation ,recovery of intestinal function after operation, hospital stay, use of analgesic and transfusion blood or plasma in group A were significantly reduced than those in group B （P〈 0.01 ）. Conclusions As compared with open radical nephrectomy,retroperitoneal laparoscopic radical nephreclomy affords patients with renal cell carcinoma an improved postopqrative course with minimal invasion, less pain, quicker recovery and less complications, while providing equally effective cancer control for patients with T1N0M0 or T2N0M0 tumor.

关 键 词：肾肿瘤 腹腔镜 肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]