三种保留肾单位术式对局限性肾癌疗效及安全性的对照研究  

Comparative study of the efficacy and safety of three kinds of nephron sparing surgery for localized renal cell carcinoma

作　　者：代宏[1] 余志海[1] 何东林[1] 王春梅[1] 

机构地区：[1]重庆三峡中心医院泌尿外科,重庆4040000

出　　处：《癌症进展》2016年第8期790-792,共3页Oncology Progress

摘　　要：目的：比较经腹腹腔镜手术、经腹膜后腹腔镜手术、开放性手术三种术式治疗局限性肾癌的疗效及安全性。方法将120例局限性肾癌患者根据手术方式的不同分为A、B、C三组各40例，均接受保留肾单位术式。其中A组采用经腹腹腔镜手术，B组采用经腹膜后腹腔镜手术，C组采用开放性手术。比较三组疗效、手术情况、术中及术后并发症及治疗前后肾功能指标的差异。结果 A组及B组肾动脉阻断时间及手术时间均长于C组，术中出血量少于C组，住院时间短于C组，差异均具有统计学意义（P﹤0.05）。术前及术后三组肾功能指标GFR、BUN及Scr比较，差异无统计学意义（P﹥0.05）。随访2~4年，三组患者死亡、复发、转移情况比较，差异无统计学意义（P﹥0.05），术中及术后并发症比较，差异无统计学意义（P﹥0.05）。结论经腹腹腔镜和经腹膜后腹腔镜保留肾单位手术对局限性肾癌疗效可靠，安全性高，且组织创伤小，患者恢复快，优于开放性手术。Objective To compare the efficacy and safety of transabdominal laparoscopic surgery, retroperitoneal lap-aroscopic surgery, and open surgery in the treatment of localized renal cell carcinoma （RCC）. Method 120 cases of local-ized RCC patients were enrolled in the study, and were stratified as three groups according to respective nephron sparing surgeries, including transabdominal laparoscopic surgery （Group A）, retroperitoneal laparoscopic surgery （Group B）, and open surgery （Group C）, with 40 cases in each. The efficacy, outcome, pre-and post-operative complications and renal function before and after treatment of the three groups were compared. Result The renal artery occlusion time and the operative time of group A and B were significantly longer, while intra-operative blood loss were less, and hospital stay were shorter than those of group C, with significant differences observed （P〈0.05）. There were no statistically significant differences regarding renal function indexes of GFR, BUN and Scr in the three groups （P〉0.05）. After 2~4 years of fol-low up, similar results were observed in three groups in respect of death, recurrence, metastasis rate （P〉0.05）, besides, the incidences of intraoperative and postoperative complications in these groups were consistent either （P〉0.05）. Conclusion Transabdominal laparoscopic surgery and retroperitoneal laparoscopic surgery are effective in treating localized renal cell carcinoma, with excellent safety and minor invasiveness, as well as fast recovery, as compared with open surgery.

关 键 词：肾肿瘤 腹腔镜 局限性肾癌 手术 肾功能 

分 类 号：R737.11[医药卫生—肿瘤]