后腹腔镜联合腹股沟小切口治疗上尿路尿路上皮癌的前瞻性研究  

A prospective study of inguinal incision in retroperitoneal laparoscopy in the treatment of upper urinary tract urothelial carcinoma

作　　者：李志强 王科[2] 王琳[2] 孙良坤 林春华[2] 高振利[2] 

机构地区：[1]牟平区中医医院泌尿外科,山东烟台264000 [2]青岛大学附属烟台毓璜顶医院泌尿外科,山东烟台264000

出　　处：《现代泌尿外科杂志》2017年第7期537-540,共4页Journal of Modern Urology

摘　　要：目的探讨后腹腔镜联合腹股沟小切口根治性肾输尿管切除术治疗上尿路尿路上皮癌的临床应用价值。方法将2014年6月至2016年8月收治的上尿路尿路上皮癌70例,采用前瞻性临床对照研究方法,按入院顺序分为两组,袖状组(n=35)采用后腹腔镜联合腹股沟切口膀胱袖状切除术,电切组(n=35)采用后腹腔镜联合经尿道电切术,比较两组手术时间、术中出血量、住院时间、术后肿瘤复发等指标。结果两组手术均顺利完成,无中转开放手术,未出现死亡及重大并发症。两组手术术中出血量、肿瘤分期和肿瘤分级方面比较均无统计学意义(P>0.05)。袖状组手术时间[(105.3±11.2)min]、住院时间[(6.4±2.2)d]少于电切组手术时间[(117.5±15.4)min]、住院时间[(7.6±3.5)d],袖状组肿瘤复发率(8.8%)低于电切组(26.5%)。结论后腹腔镜联合腹股沟小切口根治性肾输尿管切除术治疗上尿路上皮癌具有手术简单快捷、住院时间少、肿瘤复发率低等特点;是基层医院治疗上尿路上皮癌的首选手术术式。Objective To investigate the applicative value of inguinal incision in retroperitoneal laparoscopic nephroure- terectomy （RLNU） in the treatment of upper urinary tract urothelial carcinoma （UUTUC）. Methods A total of 70 UUTUC cases treated during Jun. 2014 and Aug. 2016 were involved. Based on the admission sequence, these cases were divided into 2 groups：group A （n=35, received retroperitoneal laparoscopy combined with inguinal incision of bladder cuff resection）, and group B （n= 35, received laparoscope combined with transurethral electrotomy）. The operation time, hospital stay, tumor staging and grading, postoperative tumor recurrence of the 2 groups were compared. Results All operations were successful, There were no differences in tumor stage, tumor grade and blood loss between the 2 groups （P〉0.05）. The mean operation time, hospital stay and postoperative tumor recurrence of group A and B were （105.3±11.2） vs. （117.5± 15.4）min, （6.4±2.2） vs. （7.6±3.5）d, 8.8% vs. 26.5 %, with significant differences between the 2 groups （P〈0.05）. Corlclusions Retro- peritoneal laparoscopy combined with inguinal incision of bladder cuff resection for UUTUC has advantages of short operation time, short hospital stay and low tumor recurrence. It can be wide spread in primary hospitals.

关 键 词：腹腔镜 尿路上皮癌 腹股沟切口 经尿道电切 并发症 

分 类 号：R737.11[医药卫生—肿瘤]