经腹膜后和经腹腹腔镜下肾根治性切除术的比较  

Comparison of transperitoneal and retroperitoneal laparoscopic radical nephrectomy

作　　者：王浩飞[1] 徐兆平[1] 黄欣[1] 张翀宇[1] 芮文斌[1] 孙福康[1] 祝宇[1] 沈周俊[1] 

机构地区：[1]交通大学附属瑞金医院泌尿外科,上海200025

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第4期5-8,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较经腹膜后和经腹腹腔镜下肾根治性切除术的疗效。方法对2010年1月到2013年12月期间上海交通大学附属瑞金医院152例腹腔镜下肾根治性切除术患者进行回顾性分析,其中经腹腔路径组78例,经后腹腔路径组74例,比较这两种手术路径在肿瘤大小、手术时间、出血量、术后肠道恢复时间、术后住院时间、并发症以及预后等方面的差异。结果所有手术均在腹腔镜下完成,没有中转开放。经腹路径组的手术时间、术中出血量、术后肠道恢复时间、术后住院时间和肿瘤大小分别为(138.0±31.8)min、(118.0±72.6)ml、(1.8±1.3)d、(5.8±2.3)d、(6.8±3.2)cm,经腹膜后路径组分别为(121.2±20.4)min、(109.4±67.2)ml、(1.7±1.5)d、(5.4±2.7)d、(5.3±2.1)cm。经腹路径的手术时间、肿瘤大小和经腹膜后路径相比有明显差异(P<0.05)。两组在术中出血量、术后肠道恢复时间和术后住院时间方面无明显差异(P>0.05)。结论对于根治性肾切除,无论是采用经腹还是经腹膜后路径均能取得良好的手术效果。对于体积较大的肿瘤,经腹路径可能更适合。Objective To compare the efficacy of transpefitoneal and retropefitoneal laparoscopic radical nephrectomy. Methods 152 patients underwent laparoscopic radical nephrectomy （78 transperitoneal and 74 retroperitoneal nephrectomy） from January 2010 to December 2013 in Ruijin Hospital, Jiaotong University. The data of the tumor size, operative time, blood loss, bowel function recovery, postoperative hospital stay, operative complications and prognosis between thetransperitoneal and retroperitonealapproach were analyzed. Results All the operations were completed by laparoscopy. The operative time, tumor size, blood loss, bowel function recovery and postoperative hospital stay in transperitoneal approach were （138.0±31.8） rain, （118.0±72.6） ml, （1.8±1.3） d, （5.8.±.2.3） d, （6.8±3.2） cm respectively, while they were （121.2±220.4）min, （109.4±67.2）rnl, （1.7±1.5） d, （5.4±2.7） d, （5.3±2.1） cm respectively in retroperitoneal approach. The operative time and tumor size in transperitoneal approach were longer and larger than retroperitoneal approach （P〈0.05）. The blood loss, bowel function recovery and postoperative hospital stay between these two approach had no significant differences （P〉0.05）. Conclusions Both transperitoneal and retropefitoneal approach can achieve good effect in radical nephrectomy. The transperitoneal approach maybe more suitable for tumors with larger size.

关 键 词：肾肿瘤 腹腔镜 手术 

分 类 号：R737.11[医药卫生—肿瘤]