不同入路下腹腔镜手术治疗大体积肾癌的临床疗效对比  

Comparison of Clinical Effect of Laparoscopic Surgery under Different Approach in Large Volume Kidney Cancer

作　　者：张进[1] 蔡红艳[1] 高飞[1] 

机构地区：[1]陕西省榆林市第二医院,719000

出　　处：《实用癌症杂志》2017年第6期1017-1020,共4页The Practical Journal of Cancer

摘　　要：目的探讨不同入路下腹腔镜手术治疗大体积肾癌的临床疗效和安全性。方法将105例大体积肾癌患者根据手术时间的先后分为经腹腔组(n=52)和经腹膜后组(n=53),比较2组的围术期指标(手术时间、术中出血量、术后胃肠功能恢复时间、住院时间)、血清肿瘤标志物[糖类抗原50(CA50)、CA125和血清癌胚抗原(CEA)的水平]、血清炎症因子[白介素(IL)-6、IL-12和IL-1β]水平。结果经腹膜后组的手术时间、术后胃肠功能恢复时间和住院时间显著短于经腹腔组(P<0.05)。手术前及手术后第4周经腹膜后组和经腹腔组的血清CA125、CA50、CEA水平比较,组间差异均无统计学意义(P>0.05);手术后第4周,2组的血清肿瘤标志物水平均较手术前显著降低(P<0.05)。手术前,经腹膜后组和经腹腔组的血清IL-6、IL-12、IL-1β水平比较,差异无统计学意义(P>0.05);手术后第1天,经腹膜后组和经腹腔组的血清IL-6、IL-12、IL-1β水平均较治疗前显著升高(P<0.05),而经腹膜后组均低于经腹腔组,但差异无统计学意义(P>0.05)。2组并发症发生率比较(5.7%vs7.7%),差异无统计学意义(P>0.05)。结论经腹腔入路和经腹膜后入路腹腔镜手术治疗大体积肾癌均安全有效,临床医师可根据患者的病情合理选择腹腔镜的入路方式。Objective To investigate the clinical effect of laparoscopic surgery under different approach in large volume of kidney cancer. Methods 105 cases of patients with large volume of kidney cancer were selected and divided into abdominal cavity group （ n = 52 ） and retroperitoneal group （ n = 53 ）. Compared the perioperative indicators （ operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, hospital stays, serum tumor markers （ carbohydrate antigen 50 （ CAS0）, serum embryonal carcinoma antigen （ CEA）, CA125 ）, serum inflammatory factors （ interleukin （IL） -6, IL -12 and IL - 1β）. Results Operation time, postoperative gastrointestinal function recovery time, hospital stays of the retroperitoneal group were significantly shorter than that of the abdominal cavity group （P 〈 0.05 ） ; After operation, the levels of serum tumor markers and inflammatory factors of the retroperitoneal group were significantly lower than that of the abdominal cavity group（P 〈 0.05 ）. Conclusion Laparoscopic surgery by abdominal cavity or retroperitoneal approach for large volume kidney cancer is effective and safe. Clinicians should choose reasonable laparoscopic approach according to the patient＇s integrated circumstance.

关 键 词：肾癌 大体积 腹腔镜 入路方式 

分 类 号：R737.11[医药卫生—肿瘤]