腹腔镜下不同入路手术与开放式切除术治疗大体积肾癌的疗效及安全性分析  

Clinical efficacy and safety of different operative approaches of laparoscopic operation and open resection in therapy of renal cell carcinoma

作　　者：石奇刚[1] 孙永恒[1] 任艳胜[1] 

机构地区：[1]河南省濮阳市人民医院泌尿外科,457000

出　　处：《中国实用医刊》2017年第3期39-41,共3页Chinese Journal of Practical Medicine

摘　　要：目的：对比分析腹腔镜下不同入路手术与开放式切除术治疗大体积肾癌的疗效及安全性。方法选择2012年1月至2015年12月93例肾脏肿瘤患者作为研究对象，根据手术方式不同分为腹膜组、腹腔组及开放组，每组31例。腹腔组选用经腹腔入路腹腔镜手术，腹膜组选用经腹膜后入路腹腔镜手术，开放组选用开放手术，统计三组患者术后病理检查结果及手术情况。结果腹膜组肾透明细胞癌发生率为93.54％（29/31），腹腔组肾透明细胞癌发生率为96.77％（30/31），开放组为93.54％（29/31），三组比较差异未见统计学意义（P ＞0.05）；腹膜组及腹腔组手术时间明显长于开放组，且腹腔组长于腹膜组，差异均有统计学意义（P ＜0.05）；开放组术中出血量明显多于腹膜组及腹腔组，差异有统计学意义（P ＜0.05），腹膜组与腹腔组比较差异未见统计学意义（P ＞0.05）。结论采用腹腔镜手术治疗大体积肾癌患者效果显著优于开放式手术，可根据患者病情等情况选取经腹腔入路或经腹膜后入路方式，提高治疗效果及预后效果。Objective To compare the efficacy and safety of laparoscopic surgery and open surgery in treatment of large volume renal cell carcinoma. Methods Ninety-three patients with kidney cancer from January 2012 to December 2015 were selected as the research subjects. According to the＆nbsp;different operation methods,they were divided into the peritoneal group,the abdominal group and the open group with 31 cases in each group. The abdominal group was treated by laparoscopic operation,and the peritoneum group was treated by retroperitoneal laparoscopic surgery,open group used open surgery. Postoperative pathological examination results and operation status of the three groups were statistically analyzed. Results Peritoneal group of renal clear cell carcinoma occurrence rate was 93. 5%（29 / 31）, abdominal group renal clear cell cancer rate was 96. 77% （ 30 / 31 ） and open group was 93. 5%（29 / 31）,the differences had no significant among the three groups（P 〉 0. 05）;the operative time of abdominal and peritoneal group were significantly longer than those in the open group,the abdominal group was longer than peritoneum group,and the differences were significant（P〉 0. 05）. Conclusions The effect of laparoscopic surgery on large volume of renal cell carcinoma was significantly better than that of open surgery. It can be selected according to the patient’s condition by intraperitoneal approach or retroperitoneal approach mode,so that it can improve the therapeutic effect and prognosis.

关 键 词：腹腔镜 经腹腔入路 腹膜后路径 开放式切除术 大体积肾癌 

分 类 号：R737.11[医药卫生—肿瘤]