腹膜后全腹腔镜下肾输尿管全长切除术治疗上尿路尿路上皮癌  

Retroperitoneal laparoscopic radical nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma

作　　者：郑鹏 傅点 徐晓峰 位志峰 李平 徐锋 张征宇 葛京平 周文泉 程文 ZHENG Peng;FU Dian;XU Xiaofeng;WEI Zhifeng;LI Ping;XU Feng;ZHANG Zhengyu;GE Jingping;ZHOU Wenquan;CHENG Wen(Department of Urology, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China)

机构地区：[1]南京大学医学院附属金陵医院泌尿外科,210002

出　　处：《现代泌尿生殖肿瘤杂志》2019年第1期20-23,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的评价腹膜后全腹腔镜下肾输尿管全长切除术治疗上尿路尿路上皮肿瘤的安全性及有效性。方法 41例上尿路尿路上皮肿瘤患者,其中观察组17例行全腹腔镜下手术,对照组24例行腹腔镜结合电切镜手术,分析比较两组患者的临床疗效及随访结果。结果两组41例患者均成功进行手术,观察组与对照组的平均手术时间分别为(113.7±12.6)和(132.4±15.8)min,P<0.05;两组术中平均出血量分别为(67.5±8.6)和(109.4±7.1)ml,P<0.05;术后平均住院时间分别为(4.8±1.3)和(5.2±1.4)d,P>0.05,所有患者均留置导尿管出院;术后复发率分别为11.76%、20.83%,P>0.05。两组患者术后住院时间及术后复发率均无明显差异,观察组在手术时间、术中出血量方面均优于对照组。所有患者围手术期均未出现严重并发症。结论相较于目前常用的腹腔镜联合电切镜手术方式,腹膜后全腹腔镜下肾输尿管全长切除术手术时间短、术中出血少。该手术方式切实可行,安全有效。Objective To evaluate the effectiveness and safety of retroperitoneal laparoscopic radical nephroureterectomy for upper urinary tract urothelial tumor. MethodsFrom March 2011 to September 2014, 41 cases with upper urinary tract urothelial tumor underwent radical nephroureterectomy. The patients were divided into two groups according to different surgery methods (group A: retroperitoneal laparoscopic radical nephroureterectomy, group B: retroperitoneal laparoscopic nephroureterectomy with excision of bladder cuff). We analyzed their clinical data and compared two sets of surgical time, blood loss and surgical results. ResultsThe operation was successfully completed in the 41 cases. The average operation time of the observation group and the control group were (113.7±12.6),(132.4±15.8) min, P <0.05. And the blood loss were (67.5±8.6),(109.4±7.1) ml, P <0.05. The average postoperative hospital stay were (4.8±1.3),(5.2±1.4) d, P >0.05. All patients were discharged with the catheter. Postoperative recurrence rate: 11.76%, 20.83%, P >0.05. All the patients successfully underwent the surgery, and no severe complications were observed during the perioperative period. Compared to group B, group A has better results in operation time and blood loss. ConclusionsCompared to retroperitoneal laparoscopic nephroureterectomy with excision of bladder cuff, retroperitoneal laparoscopic radical nephroureterectomy has shorter operation time and less blood loss. It was practicable, safe and effective.

关 键 词：肾输尿管切除术 腹腔镜 尿路上皮肿瘤 

分 类 号：R737.1[医药卫生—肿瘤]