肾细胞癌后腹腔镜下根治性切除的临床研究  

Clinical study of retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma

作　　者：张运涛[1] 袁建林[1] 汪涌[2] 邵晨[1] 秦卫军[1] 秦军[1] 刘贺亮[1] 张更[1] 王福利[1] 杨力军[1] 刘飞[1] 

机构地区：[1]第四军医大学西京医院泌尿外科,陕西西安710032 [2]第四军医大学唐都医院泌尿外科,陕西西安710038

出　　处：《现代泌尿外科杂志》2009年第2期88-90,共3页Journal of Modern Urology

基　　金：国家科技攻关计划课题资助(No.2004BA720A12);陕西省科技攻关计划资助(No.2005K12-64)

摘　　要：目的探讨肾细胞癌后腹腔镜下根治性切除术的临床应用价值。方法回顾性分析后腹腔镜下根治性肾切除术(A组32例)及开放性根治性肾切除术(B组51例)的临床资料。比较两组手术时间、术中出血量、术后肠功能恢复时间、局部复发、切口种植转移等指标。结果A组手术时间中位数75(50～150)min,术中出血量中位数60(20～450)mL。术后肠功能恢复时间中位数1.5(1～2)d,术后切口感染4例(12.5%),切口侧下腹部皮肤感觉过敏者7例(21.9%);B组手术时间中位数100(75～180)min,术中出血量中位数150(100～500)mL。术后肠功能恢复时间中位数2(1～3)d,术后切口感染6例(11.8%)。切口侧下腹部皮肤感觉过敏者17例(33.3%)。两组均无严重并发症出现。A组在手术时间、术中出血量、术后肠功能恢复时间方面明显优于B组(P<0.01)。结论后腹腔镜下根治性肾切除术较开放手术治疗肾癌具有微创、安全、可靠等特点。无局部重要脏器及大血管浸润和黏连的肾癌病例均适合行后腹腔镜手术切除。Objective To explore the clinical value of retroperitioneal laparoscopic radical nephrectomy for renal cell carcinoma. Methods From January 2003 to December 2007, the Clinical data of 32 patients who underwent retroperitoneoscopic radical nephrectomy （group A） and 51 patients who underwent open radical nephrectomy （group B） were analysed retrospectively. Variables including side effect, operative and postoperative date （operating time, estimated blood loss, recovery of intestinal function, postoperative complication, analgesic requirements, postoperative hospital stay, local recurrence, port site metastases） were compared between the groups. Results In group A, the medians of operating time, blood loss, and recovery of intestinal function were 75 （range 50- 150）min, 60（20-450）mL, and 1.5 （range 1-2） days, respectively. There were no major complications. Minor complications were noted in 4 cases （12.5%） with wound infection and 7 cases （21.9%） with local paraesthesia. In group B, the medians of operating time, blood loss, and recovery of intestinal function were 100 （75-180）min, 150 （100-500）mL, and 2 （range 1-3） day. There were no major complications. Minor complications included wound infection in 6 cases （11.8%） and local paraesthesia in 17 cases （33.3%）. The differences of the variables betwent the two groups were sigitieant （P〈0.01）. Conclusion Retroperitonescopic radical nephreetomy for renal cell carcinoma is characterized by microtrauma, safety, and reliability and can be applied to cases without metastatic carcinoma, vital organs or blood vessels involved.

关 键 词：后腹腔镜术 肾细胞癌 根治性肾切除术 

分 类 号：R699.2[医药卫生—泌尿科学]