后腹腔镜联合电切镜治疗肾盂肿瘤的效果与安全性分析  

The efficacy and safety of retroperitoneal laparoscopy combined with resectoscope in the treatment of renal pelvic tumors

作　　者：袁耀宇[1] 刘世雄[1] 张鑫圣[1] 章祖招 张文刚[1] 王慧[1] 林棋[1] 何剑[1] 

机构地区：[1]台州市中心医院泌尿外科,浙江台州318000

出　　处：《中华全科医学》2017年第5期779-781,共3页Chinese Journal of General Practice

摘　　要：目的对比后腹腔镜联合电切镜与传统开放手术治疗肾盂肿瘤的效果与安全性。方法按照手术方法不同,将2008年1月—2016年1月间台州市中心医院行手术的102例肾盂肿瘤患者分成观察组与对照组,观察组采用后腹腔镜联合电切治疗,对照组采用传统开放手术治疗。分别比较2组的术中出血量、手术时间、术后肛门恢复通气时间、术后留置引流管时间、术后首次下床活动、住院时间等各项指标,观察2组的术后并发症。术后随访,包括病史、尿液分析、肝肾功能、彩超、胸部X线片、膀胱镜等内容,观察1年内的转移和复发情况(发现膀胱癌情况)。对数据进行统计学分析,进而分析后腹腔镜联合电切镜术治疗肾盂肿瘤的效果与安全性。结果观察组的术中出血量、手术时间、术后肛门恢复通气时间、术后留置引流管时间、术后首次下床活动、住院时间明显短于对照组,比较差异具有统计学意义(P<0.05);观察组并发症率为4.41%,显著低于对照组的20.59%(P<0.05);术后随访1年,2组患者的肿瘤局部复发率、皮肤切口转移率以及远处肿瘤转移率差异没有统计学意义(P>0.05)。结论腹腔镜联合电切镜治疗肾盂肿瘤有效地减少了手术创伤,促进了术后恢复,降低了并发症的发生率。Objective The comparison of retroperitoneal laparoscopy combined with resectoscope and traditional open sur- gery in the treatment of renal pelvic tumors. Methods According to different surgical methods, 102 patients with renal pelvic tumors between January ,2008 and January,2016 were divided into the observation group and control group. The ob- servation group was treated by retroperitoneal laparoseopie resection, while the control group was treated by traditional open surgery. To compare intraoperative blood loss, operation time, postoperative anal ventilation time, postoperative drain- age drainage time, postoperative first ambulation, length of stay and complications. All patients were postoperative followed- up, including history, urine analysis, liver and kidney function, color Doppler ultrasound, chest X-ray film, eystoscopy and other content, metastasis and recurrence （bladder cancer status）. All data were statistical analyzed to investigate the effect and safety of retroperitoneal laparoscopy combined with resectoscope. Results The intraoperative blood loss of in the ob- servation group was significantly less than that of the control group, Operation time, postoperative anal recovery time, dura- tion of postoperative indwelling drainage, postoperative first ambulation and hospital stay were significantly shorter than those of the control group, the difference was significant （P 〈 0.05） ;The total incidence of intraoperative and postopera- tive complications in the observation group was significantly lower than that in the control group （ P 〈 0.05 ） ; The patients were followed up for 1 year,There was no significant difference in local recurrence rate, skin incision metastasis rate and distant tumor metastasis rate between the two groups （P 〉 0.05 ）. Conclusion Laparoscopic combined resectoscope in treatment of renal pelvis tumors effectively reduce the surgical trauma, and promote postoperative recovery, reduce the inci- dence of complications.

关 键 词：腹腔镜 电切镜 肾盂肿瘤 

分 类 号：R737.11[医药卫生—肿瘤] R730.56[医药卫生—临床医学]