后腹腔镜与开放肾部分切除术治疗局限性肾癌的疗效比较  

Comparison of retroperitoneal laparoscopic and open partial nephrectomy in local renal cell carcinoma

作　　者：张宇[1] 刘东[2] 胡岚亭[1] 汪清[1] 

机构地区：[1]新疆维吾尔自治区人民医院泌尿外二科,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院小儿外科,乌鲁木齐830001

出　　处：《中华腔镜泌尿外科杂志（电子版）》2013年第1期8-11,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较腹腔镜肾部分切除术(LPN)与开放肾部分切除术(OPN)两种手术方法治疗局限性肾肿瘤的效果。方法回顾性分析我院2007年10月至2011年9月间共68例肾部分切除术的完整临床资料,其中31例行LPN,37例行OPN。对两组患者的手术时间、术中肾热缺血时间、术中出血量、术后引流量、术后引流管留置时间、术后胃肠功能恢复时间、术后住院时间、术后并发症及手术前后血清肌酐水平进行比较分析。结果两组患者术后引流量、术后引流管留置时间和术后并发症比较无统计学差异(P>0.05)。LPN组与OPN组相比,手术时间及术中肾脏热缺血时间长,差异有统计学意义(P<0.01);而术中出血量、术后胃肠功能恢复时间、术后住院时间均优于OPN组,差异有统计学意义(P<0.05)。两组患者术后血清肌酐升高幅度差异无统计学意义(P>0.05)。结论尽管LPN手术时间及术中肾缺血时间长,LPN与OPN治疗局限性肾癌相比,仍是一种安全、有效、微创的方法。Objective To compare the effect of laparoscopic partial nephrectomy （LPN） with open partial nephrectomy （OPN） in the treatment of local renal cell carcinoma. Methods We retrospectively analysed the data of 68 cases of partial nephrectomy in our hospital from October 2007 to September 2011, including 31 cases of laparoscopic partial nephrectomies and 37 cases of open partial nephrectomies. Variables compared included operation time, warm ischemic time, blood loss, amount and time of drainage, time of anal exsufflation, postoperative hospital stay, postoperative complication and creatinine levels before and after partial nephrectomy. Letters, telephone and postoperative table were used in follow-up. Results There was no significant difference in postoperative complication, amount and time of drainage （P〉0.05）. LPN group was obviously superior to OPN group in blood loss, time of anal exsufflation, and postoperative hospital stay （P〈0.05）. But in the operation time, warm ischemia time, LPN group was obviously inferior to OPN group （P〈0.01）. There was no significant difference between the two groups in creatinine increased after operation. Conclusions Though the laparoscopic approach is associated with longer operation time and warm renal ischemic time, laparoscopic partial nephrectomy for the treatment of localized renal tumor has the advantages of minimal invasion and efficiency.

关 键 词：肾细胞癌 保留肾单位手术 腹腔镜 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]