后腹腔镜下肾输尿管切除术联合经尿道电凝治疗上尿路尿路上皮癌的前瞻性临床对照研究  

A prospective clinical controlled study of retroperitoneal laparoscopic nephroureterectomy combined with transurethral electric coagulation for upper urinary tract urothelial carcinoma

作　　者：王健涛[1] 张春红[1] 于胜强[1] 王科[1] 门昌平[1] 高振利[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院泌尿外科,264000

出　　处：《中华泌尿外科杂志》2014年第12期905-908,共4页Chinese Journal of Urology

基　　金：山东省自然科学基金（Y2008C49）

摘　　要：目的 探讨后腹腔镜下肾输尿管切除术联合经尿道电凝治疗上尿路尿路上皮癌的临床疗效. 方法 收集我院2012年6月至2013年4月收治的上尿路尿路上皮癌患者60例,采用前瞻性临床对照研究方法,按入院顺序分为两组,实验组（n=30）采用后腹腔镜下肾输尿管切除术联合经尿道电凝治疗,对照组（n=30）采用后腹腔镜下肾输尿管切除术联合经尿道电切治疗.比较两组的手术时间、术中出血量、术后住院时间以及术后肿瘤复发率. 结果 两组手术均顺利完成,无中转开放手术,未出现大血管或邻近脏器损伤等术中并发症.实验组失访2例,对照组失访3例,两组手术时间、术中出血量、随访时间、肿瘤分期和肿瘤分级比较差异均无统计学意义（P＞0.05）.实验组术后住院时间[（5.5±2.0）d]和肿瘤复发率[4％（1/28）]与对照组[（7.1±2.2）d,30％（8/27）]比较差异均有统计学意义（P＜0.05）. 结论 与后腹腔镜下肾输尿管切除术联合经尿道电切相比,后腹腔镜下肾输尿管切除术联合经尿道电凝治疗上尿路尿路上皮癌能够缩短患者住院时间、降低肿瘤复发率.Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic nephroureterectomy （RLNU） combined with transurethral electric coagulation on upper urinary tract urothelial carcinoma （UUTUC）.Methods Sixty UUTUC patients were enrolled from Jun.2012 to Apr.2013.The prospective clinical controlled analysis method was adopted in this study.All patients were divided into test group and control group according to the order of admission.Thirty cases （test group） underwent RLNU combined with electric coagulation,and 30 cases （control group） underwent RLNU combined with electric resection.The differences in operation time,blood loss,hospital stay and tumor recurrence rate between the 2 groups were compared.Results All the 60 operations for UUTUC were successful without conversion to open surgery.No intraoperative complications such as great vessels or surrounding organs damage occurred.There were 2 cases loss to follow-up in test group and 3 cases in control group.There were no significant differences in operation time,blood loss,follow-up time,tumor stage and tumor grade between the 2 groups.The hospital stay in the test group was shorter （5.5±2.0 d versus 7.1±2.2 d）,the tumor recurrence rate was lower [4％ （1/28） versus 30％ （8/27）],and the differences were significant （P＜0.05）.Conclusion Compared with RLNU combined with transurethral electric resection,RLNU combined with electric coagulation has advantages of shorter hospital stay and lower tumor recurrence rate.

关 键 词：腹腔镜 上尿路尿路上皮癌 膀胱肿瘤 经尿道电凝 临床对照试验 

分 类 号：R737.1[医药卫生—肿瘤]