后腹腔镜下肾盂癌根治术与开放手术的临床对比  

Comparison of laparoscopic nephroureterectomy and open surgery

作　　者：侯国栋 何朝宏 冯超杰 李靖 

机构地区：[1]郑州大学附属肿瘤医院泌尿外科,郑州450003

出　　处：《医药论坛杂志》2014年第5期41-42,45,共3页Journal of Medical Forum

摘　　要：目的通过对比后腹腔镜辅助下肾盂癌根治术与传统开放手术两种手术方式，评估后腹腔镜辅助手术治疗肾盂癌的临床价值。方法回顾性分析肾盂癌患者31人，比较2组的手术时间、术中出血量、术后肠道功能恢复时间、术后拔除腹腔引流管时间、术后并发症及术后住院时间来评估两种术式的差异。结果31例手术均顺利完成，腔镜组和开放手术组的平均手术时间分别为（148．11±22．58）min和（178．08±37．83）min，术中平均出血量分别为（127．22±63．41）ml和（296．15±234．90）ml，术后肠道功能恢复时间分别为（2．06±0．72）d和（3．08±0．76）d，术后拔除腹腔引流管时间分别为（3．56±0．98）d和（5．69±2．72）d，术后住院时间分别为（9．17±2．03）d和（14．69±6．18）d。术后随访2—19个月，两组患者在随访期间均未发生肿瘤复发及转移。开放手术组1例患者发生术后切口感染，对症处理后痊愈，两组均无死亡病例。结论后腹腔镜辅助下肾盂癌根治术能有效治疗。肾盂癌，术中视野更清晰，手术创伤小，出血量少，术后恢复快，是替代传统开放手术的理想术式之一。Objective To evaluate the clinical value of the retroperitoneoscopy-assisted renal pelvis carcinoma radical resection by comparing two ways between the retroperitoneoscopy-assisted surgical treatment and the traditional open operation. Methods This retrospective study employed data from 31 Renal pelvis carcinoma patients from 2011 to 2013. In order to evaluate the differences between these two surgical methods, these patients were divided into two groups which were the cavity mirrors group and open surgery group with comparing the time of operation, intraoperatve blood soss, Postoperative bowel function recovery time and urethral abdominal cavity drainage tube pulling-out time, the postoperative complications and the postoperative hospitalization duration. Results Totally 31 cases were all performed smoothly. The operative time, peri-operative bleeding volume, Postoperative bowel function recovery time, Postoperative urethral abdominal cavity drainage tube pulling-out time and the postoperative hospitalization duration between the cavity mirrors group and open surgery group were （ 148.11 ± 22.58 ） min and （ 178.08 ± 37.83 ） min, （ 127.22 ± 63.41 ） ml and （296. 15 ±234. 90）ml,（2. 06 ±0. 72）d and （3.08 ±0. 76）d, （3.56 ±0. 98）d and （5.69 ±2. 72）d, （9. 17 ±2.03） d and （14. 69 ± 6. 18 ）d, respectively. During two to nine months follow-up, our investigation showed that there were no recurrences, metastases and deaths in two groups and one patient who was infected has recovered after accurately treatments. Conclusion The retroperitoneoseopy-assisted renal pelvis carcinoma radical resection has a better advantage in clearer view, less lesion, less bleeding, faster recovery, future investigation may consider it for ideal surgical method instead of the traditional open operation.

关 键 词：肾肿瘤 肾盂 腹腔镜 肾输尿管全切术 

分 类 号：R737.11[医药卫生—肿瘤]