不同肾盂癌根治术式的疗效观察  

Comparison of different radical resection of renal pelvis carcinoma

作　　者：于俊杰[1] 温儒民[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,徐州221002

出　　处：《河南外科学杂志》2013年第5期3-5,共3页Henan Journal of Surgery

摘　　要：目的比较后腹腔镜根治性肾切除联合经尿道电切及联合下腹部小切口治疗肾盂癌的手术方法及效果。方法回顾性分析11例后腹腔镜肾输尿管全切联合经尿道膀胱输尿管袖套状切除（电切组）及15例联合下腹部小切口（切口组）进行肾盂癌根治术患者的临床资料，通过对手术时间、术中出血量、术后肠道恢复时间、术后住院时问、局部复发及转移等数据进行统计，对两种术式的操作步骤进行比较、总结并以同期开展的16例开放性肾盂癌根治性手术（开放组）做对照。结果电切组及切1：3组手术时间、出血量、肠道恢复时间、引流管拔出时间、术后住院天数比开放组均有明显优势，差异有统计学意义（P〈0．05）。电切组与切1：3组手术时间、引流管拔除时间比较，差异有统计学意义（P〈0．05）。术中出血量、术后住院天数、局部复发及转移，差异无统计学意义（P〉0．05）。切口组1例，开放组2例出现术后切口感染。术后随访3～39个月，电切组1例局部复发，1例发生膀胱癌；切口组1例发生膀胱癌，1例肺转移。开放组1例局部复发，1例发生膀胱癌，1例肺转移。结论电切组较切口组手术时间短，没有增加出血量及术后复发、转移、肿瘤种植风险，但无下腹部切口，具有创伤小、恢复快、美观等优点，值得临床推广应用。Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic radical nephrectomy combined with transurethral electro - vaporization and combined with abdominal small incision in the treatment of renal pelvic carcinoma. Meth- otis We retrospectively analysed the records of 11 patients who underwent retroperitoneal laparoseopic nephroureterectomy combined with tran- surethral resection of bladder ureteral cuff resection or 15 patients combined with abdominal incision from January 2009 to July march. Variables analyse including the steps and experience of this operation were compared, operative time, estimated blood loss, recovery of intestinal function ,length of stay, recurrence and metastasis included~ In the same period , open radical nephroureterectomy was performed in 16 cases as con- trol. Results There was significant difference between laparoscopic group and open group in operative time, The amount of blood loss during op- eration and the time of intestinal function recovery, drainage tube removed and hospitohzation stay after operation（ P 〈 0.05）. The time of oper- ative and drainage tube removed in ttttrrtransurethral resection group were significantly less than incision grou（ P 〈 0.05 ）. However, The a- mount of blood loss during operation and the time of intestinal function recovery and hospitohzation stay after operation were no significant differ- ence （ P 〉 0.05 ）. Incision infection occurred in 1 case of incision group and in 2 cases of open group. During the follow - up of 3 - 39 months,1 case was found recurrence and 1 case suffer from bladder tumor in transurethral resection group ; 1 case was found lung metastasis and 1 case suffer from bladder tumor in incision group;In open group, 1 case was found lung metastasis, 1 case recurrence and i case suffer from bladder tumor. Conclusion Compared with incision group and open grope, retroperitoneal laparoscopy puls urethral resection reduce the operation time, does not increase the risk of

关 键 词：肾盂癌 后腹腔镜肾切除术 经尿道电切 下腹部小切口 

分 类 号：R737.11[医药卫生—肿瘤]