经腹与经后腹膜途径行腹腔镜根治性肾切除术的临床疗效比较  

Transperitoneal versus retroperitoneal laparoscopic radical nephrectomy: a comparison of clinical outcomes

作　　者：徐遵礼[1] 王林辉[1] 陈伟[1] 杨庆[1] 刘冰[1] 吴震杰[1] 盛海波[1] 孙颖浩[1] 

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433

出　　处：《第二军医大学学报》2011年第9期938-941,共4页Academic Journal of Second Military Medical University

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12010115);上海市重点学科项目~~

摘　　要：目的比较经腹腔和经后腹膜途径行腹腔镜肾癌根治术的临床效果。方法回顾性分析258例分别经腹腔(n=116)或后腹膜(n=142)方式行腹腔镜下肾癌根治术的肾癌患者临床资料,比较2组术中手术时间、出血量、术后禁食时间及住院时间。结果经腹腹腔镜组手术时间为80～315min,平均(167±66.8)min;经后腹膜腹腔镜组为85～280min,平均(152±48.8)min,二者差异有统计学意义(P=0.034)。经腹腹腔镜组术中出血50～1 000ml,平均(181±140.4)ml;经后腹膜腹腔镜组为50～800ml,平均(171±132.9)ml,差异无统计学意义(P=0.544)。经腹腹腔镜组术后禁食时间为术后1～5d,平均为术后(2.8±1.3)d;经后腹膜腹腔镜组为术后1～5d,平均为术后(2.9±1.2)d,差异无统计学意义(P=0.801)。经腹腹腔镜组术后住院3～9d,平均(6.6±1.5)d;经后腹膜腹腔镜组为3～8d,平均(6.5±1.6)d,差异无统计学意义(P=0.477)。结论经腹腹腔镜和经后腹膜腹腔镜肾癌根治术均有良好效果,且经腹腹腔镜肾癌根治术适用于体积较大的肿瘤。Objective To compare clinical outcomes of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma（RCC） and to identify the indicators for each approach.Methods A total of 258 patients underwent transperitoneal（n=116） or retroperitoneal（n=142） laparoscopic radical nephrectomy for RCC.The operation time,blood loss during operation, fasting period after surgery and hospital stay were compared between the two groups.Results The operation time was 80-315 min（a mean of [167±66.8] min） for transperitoneal approach and 85-280 min（a mean of [152±48.8] min） for retroperitoneal approach（P=0.034）.The blood loss was 50-1,000 ml（a mean of [181±140.4] ml） for transperitoneal approach and 50-800 ml（a mean of [171±132.9] ml） for retroperitoneal approach（P=0.544）.The fasting period of surgery was 1-5 d（a mean of [2.8±1.3] d） for transperitoneal approach and 1-5 d（a mean of [2.9±1.2] d） for retroperitoneal approach（P=0.801）.The hospital stay was 3-9 d（a mean of [6.6±1.5] d） for transperitoneal approach and 3-8 d（a mean of [6.5±1.6] d） for retroperitoneal approach（P=0.477）.Conclusion Transperitoneal and retroperitoneal approaches both can yield satisfactory surgical outcomes in laparoscopic radical nephrectomy.The transperitoneal approach is suitable for tumors with a larger size.

关 键 词：肾肿瘤 腹腔镜根治性肾切除术 经腹途径 后腹膜途径 

分 类 号：R737.11[医药卫生—肿瘤]