经后腹腔镜与开放肾囊肿去顶减压术的比较  

Comparison of Retroperitoneal Laparoscopic and Open Decortication of Renal Cysts

作　　者：朱育春[1] 曾国军[1] 饶晟[1] 魏强[1] 

机构地区：[1]四川大学华西医院泌尿外科,四川成都610041

出　　处：《华西医学》2009年第5期1100-1102,共3页West China Medical Journal

摘　　要：目的:评估经后腹腔镜与开放肾囊肿去顶减压术的临床价值。方法:回顾性调查四川大学华西医院2004年4月至2008年4月468例经后腹腔镜肾囊肿去顶减压术(A组)和2003年4月至2008年4月121例开放肾囊肿去顶减压术(B组)的临床资料并进行比较,统计分析两种术式术前,术中和术后的数据资料,比如性别、年龄、侧别、囊肿直径、手术时间、术中出血量、术后下床时间、肛门排气时间、引流管拔除时间、术后住院天数、总住院天数等。开放手术均行肋缘下切口,经后腹腔镜均行腰部常规3孔穿刺。结果:所有手术均获成功。A组手术时间53.18±0.95分,术中出血6.28±0.33mL,术后肛门排气时间25.18±0.30h,术后下床时间31.02±0.22h,引流管拔除时间27.15±0.20h,术后住院4.90±0.07d,总住院8.95±0.12d;B组手术时间67.72±1.48分,术中出血51.16±0.77mL,术后肛门排气时间26.91±0.33h,术后下床时间43.31±1.03h,引流管拔除时间29.63±0.79h,术后住院7.88±0.18d,总住院12.5±0.29d。术前两组基线对比无统计差异。A组手术时间、术中出血量、术后下床时间、总住院天数和术后住院天数均优于B组,差异具有统计学意义(P<0.01)。术后肛门排气时间及引流管拔除时间无显著性差异(P>0.05)。结论:后腹腔镜肾囊肿去顶术在手术时间、术中出血量和术后下床时间等方面明显优于开放手术。Objective： To evaluate the clinical value of retroperitoneal laparoscopic decortication in the treatment of renal cyst using ultrasonic knife as compared with open surgery. Methods： Four hundred and sixty-eight retroperitoneal laparoscopic surgeries （group A） and 121 open surgeries （group B） performed in West China hospital of Sichuan university between April 2004 and April 2008 were retrospectively reviewed. Preoperative, intraoperative, and postoperative data were presented,such as the size of cysts, time of operation, mean milliliter intraoperative blood loss, mean days of hospital stay and mean days of postoperative hospital stay. A standard subcostal incision was used for the open cases while for the laparoscopie approach a 3-port retroperitoneal laparoscopic approach was used to decorticate the renal cysts. Results：All operations were successfully accomplished. In group A, we collected the data as following： the duration of operation （53.18±0.95 min）, the amount of blood lost （6.28±0.33 mL）, the time of postoperative passage of gas by anus （25.18±0.30 h）, ambulation after operation （31. 02±0.22 h）, uprooting drainage tube （27.15±0.20 h）, the postoperative hospital stay （4.90±0.07 days） and the total hospital stay （8.95±0.12 days）. Compared with group A, in group B, we got the correlated data： the duration of operation （67.72±1.48 rain）, the amount of blood lost （51.16±0.77 mL）, the time of postoperative passage of gas by anus （26.91±0.33h）, ambulation after operation （43.31±1.03 h）, uprooting drainage tube （29.63±0.79 h）, the postoperative hospital stay （7.88±0.18 days） and the total hospital stay （12.5±0.29 days）. By analyzing the two group data, the duration of operation, amount of blood lost, time of ambulation after operation, the hospital stay and the resume of normal activities after operation in group A revealed better results than those in group B （P〈0.01）. However, there were no significant difference in p

关 键 词：肾囊肿 后腹腔镜手术 去顶减压术 开放手术 

分 类 号：R699[医药卫生—泌尿科学]