后腹腔镜肾输尿管全切术治疗上尿路移行细胞癌临床分析  

Cliniceal analysis of retroperitoneal laparoscopic nephroureterectomy in the treatment of upperurinary tract transitional cell carcinoma

作　　者：伍文兵[1] 李文威[1] 

机构地区：[1]黄石市中心医院泌尿外科,435000

出　　处：《中华腔镜外科杂志（电子版）》2015年第6期37-40,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的观察后腹腔镜肾输尿管全切术治疗上尿路移行细胞癌的疗效及复发情况。方法抽取2008年1月至2013年10月行后腹腔镜肾输尿管全切术（后腹腔镜组）上尿路移行细胞癌患者40例及同期行开放手术（开放组）患者30例,比较两组的围手术期效果、术后病理结果及随访复发情况。结果后腹腔镜组的平均术中出血、术后镇痛药物用量、术后下床时间及住院时间分别为（118.9±29.4）ml、（38.5±15.0）mg、（1.5±0.4）d、（8.6±1.4）d,较开放组的（180.1±28.7）ml、（51.0±19.6）mg、（2.5±0.6）d、（10.1±1.7）d差异有统计学意义（P〈0.01）。两组的术后临床分期、随访期间（随访3~18个月）病死率及膀胱复发率比较,差异均无统计学意义（P〉0.05）。结论后腹腔镜肾输尿管全切术具有创伤小、术中出血少、术后疼痛相对轻、术后恢复快等特点,随访病死率及膀胱复发率与开放手术类似。Objective To observe the curative effect of retroperitoneal laparoscopic nephroureterectomy in the treatment of upper urinary tract transitional cell carcinoma and its recurrence. Methods 40 patients with upper urinary tract transitional cell carcinoma and treated with retroperitoneal laparoscopic nephroureterectomy from Jan. 2008 to Oct. 2013 （marked as the retroperitoneal laparoscopic group） and 30 patients treated with open surgery during the same period （ marked as the open group） were selected. The perioperative effects, postoperative pathological results and follow-up recurrence of the 2 groups were compared. Results The differences in the average intraoperative blood loss, dosage of postoperative analgesics, time of postoperative off-bed activities and length of hospital stays between the retroperitoneallaparoscopicgroup [（118.9 ± 29.4）ml,（38.5 ± 15.0）mg,（1.5 ± 0.4）d,（8.6 ± 1.4）d] and the open group [（180.1 ± 28.7）ml,（51.0 ± 19.6）mg,（2.5 ± 0.6）d,（10.1 ± 1.7）d] were statistically significant （P 〈 0.01 ）. There were no significant differences in clinical staging, mortality in follow-up period （3 to 18 months of follow-up） and the recurrence rate of bladder between the two groups （ P 〉 0.05 ）. Conclusions Retroperitoneal laparoscopic nephrectomy has the characteristics of less trauma, less intraoperative blood loss, milder postoperative pain, quicker recovery and so on. The mortality in follow- up period and the recurrence rate of bladder are similar to open surgery.

关 键 词：后腹腔镜肾输尿管全切术 上尿路移行细胞癌 临床分析 

分 类 号：R737.1[医药卫生—肿瘤]