后腹腔镜下射频消融与肾部分切除术治疗小肾癌效果比较  

Comparison of the outcome and prognosis between retroperitoneal laparoscopic radiofrequency ablation versus partial nephrectomy for small renal masses

作　　者：张宏伟[1] 刘斌[1] 党强 蔡甄波[1] 付冬冬 Zhang Hongwei;Liu Bin;Dang Qiang;Cai Zhenbo;Fu Dongdong(Department of Urology,Anyang District Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市安阳地区医院泌尿外科,455000

出　　处：《中华实验外科杂志》2020年第3期558-560,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨后腹腔镜射频消融与肾部分切除对于小肾癌(直径不超过4 cm)患者的疗效及预后。方法选取2015年1月至2017年12月河南省安阳市安阳地区医院接受后腹腔镜射频消融治疗小肾癌患者60例记作实验组;另取2012年1月至2014年12月河南省安阳市安阳地区医院接受后腹腔镜肾部分切除治疗的患者60例作为对照组。比较两组各项手术指标水平,术后并发症发生和随访情况。组间比较分别采用t检验及χ2检验。结果后腹腔镜射频消融组手术时间为(52.92±6.11)min,短于后腹腔镜肾部分切除组[(65.92±7.22)min,t=10.646,P<0.05],差异有统计学意义,后腹腔镜射频消融治疗组术后住院时间为(5.22±1.42)d,短于后腹腔镜肾部分切除治疗组[(10.87±2.61)d,t=14.729,P<0.05],差异有统计学意义,后腹腔镜射频消融组术中失血量为[(20.71±7.25)ml],少于后腹腔镜肾部分切除组[(51.05±10.82)ml,t=18.044,P<0.05],差异有统计学意义。后腹腔镜射频消融治疗术后并发症总发生率(3.33%)显著低于后腹腔镜肾部分切除治疗组(15.00%,χ2=4.904,P<0.05),差异有统计学意义。结论后腹腔镜射频消融术治疗小肾癌可获得较为明显的疗效,具有创伤小、恢复快的优势,术后随访效果与肾部分切除术类似。Objective To illustrate the effect of retroperitoneal laparoscopic radiofrequency ablation and partial nephrectomy on the efficacy and prognosis of patients with small renal masses(SRM,diameter≤4 cm).Methods From January 2015 to December 2017,60 patients with SRM who received retroperitoneal laparoscopic radiofrequency ablation were enrolled and served as the experimental group.Sixty patients undergoing retroperitoneal laparoscopic partial nephrectomy from January 2012 to December 2014 were selected as the control group.The perioperative characteristics,complications and follow-up data were compared between the two groups.Results The operation time in the retroperitoneal laparoscopic radiofrequency ablation group[(52.92±6.11)min]was significantly shorter than that in the retroperitoneal laparoscopic partial nephrectomy group[(65.92±7.22)min,t=10.646,P<0.05].The postoperative hospitalization time[(5.22±1.42)d]was significantly shorter[(10.87±2.61)d,t=14.729,P<0.05],and the intraoperative blood loss[(20.71±7.25)ml]was significantly less in the retroperitoneal laparoscopic radiofrequency ablation group than in the retroperitoneal laparoscopic partial nephrectomy group[(51.05±10.82)ml,t=18.044,P<0.05].The total incidence of postoperative complications in the retroperitoneal laparoscopic radiofrequency ablation group(3.33%)was significantly lower than that in the retroperitoneal laparoscopic partial nephrectomy group(15.00%,χ2=4.904,P<0.05).Conclusion Retroperitoneal laparoscopic radiofrequency ablation is a minimally invasive and effective treatment for SRM,with quicker recovery and similar prognosis compared to partial nephrectomy.

关 键 词：小肾癌 腹腔镜 肾部分切除 射频消融 预后 

分 类 号：R737.11[医药卫生—肿瘤]