后腹腔镜下保留肾单位手术与肾根治性切除术治疗T1b期肾肿瘤的近远期效果对比  

Comparison of short-term and long-term effects between retroperitoneal laparoscopic nephron sparing surgery and radical nephrectomy for T1b renal tumors

作　　者：扈新[1] 张玉泉[1] 杨志平[1] 郭志全[1] 王海临[1] Hu Xin;Zhang Yuquan;Yang Zhiping;Guo Zhiquan;Wang Hailin(Department of Urology,Bayannur Hopital,Bayannur 015000,China)

机构地区：[1]巴彦淖尔市医院泌尿外科,巴彦淖尔015000

出　　处：《国际泌尿系统杂志》2021年第3期431-434,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨后腹腔镜下保留肾单位手术与肾根治性切除术治疗Tlb期肾肿瘤的近远期效果。方法前瞻性分析2017年5月至2020年5月本院收治的60例T1b期肾肿瘤患者,按照随机数字表法分为观察组(行后腹腔镜下保留肾单位手术)与对照组(行肾根治性切除术),各30例。比较两组的手术指标、治疗前、后肾功能及术后并发症发生率。结果观察组患者手术时间(201.28±32.14)min、术中出血量(116.39±15.24)mL、术后引流量(65.22±12.32)mL、拔管时间(3.14±0.25)d及术后住院时间(8.63±1.12)d,与对照组[(168.29±24.93)min、(440.24±24.53)mL、(94.29±14.49)mL、(4.39±0.93)d、(11.19±2.13)d]比较,差异有统计学意义(P<0.05);观察组患者术后6个月血尿素氮(BUN)(10.12出1.79)mmol/L、血肌酐(Ser)水平(84.29±14.57)μumol/L均明显低于对照组[(22.49±2.14)mmol/L、(163.20±13.12)pumol/L],差异有统计学意义(P<0.05);观察组患者并发症发生率[6.7%(2/30)]明显低于对照组[26.7%(8/30)],差异有统计学意义(P<0.05)。结论后腹腔镜下保留肾单位手术治疗T1b期肾肿瘤,创伤小、术后恢复快,在改善患者肾功能方面作用突出,可减少并发症的发生,值得临床推广应用。Objective To investigate the short-term and long-term effects of retroperitoneal laparoscopic nephron sparing surgery and radical nephrectomy for T1b renal tumors.Methods A pro-spective analysis was performed on 60 patients with stage T1b renal tumor admitted to our hospital from May 2017 to May 2020.According to the random number table method,the patients were divided into observation group(retroperitoneal laparoscopic nephrectomy)and control group(radical nephrecto-my),with 30 cases each group.The operation indexes,renal function before and after treatment and the incidence of postoperative complications were compared between the two groups.Results The op-eration time(201.28±32.14)min,intraoperative blood loss(116.39±15.24)mL,postoperative drainage(65.22±12.32)mL,extubation time(3.14±0.25)d and postoperative hospital stay(8.63±1.12)d in the observation group were significantly higher than those in the control group(168.29±24.93)min,(440.24±24.53)mL,(94.29±14.49)mL,(4.39±0.93)d,(11.19±2.13)d in the observation group.The difference was statistically significant(P<0.05).Six months after operation,BUN(10.12±1.79)mmol/L and Ser level(84.29±14.57)umol/L in the observa-tion group were significantly lower than those in the control group(22.49±2.14)mmol/L,(163.20±13.12)μumol/L,and the differences were statistically significant(P<0.05).The inci-dence of complications in the observation group(6.7%)was significantly lower than that in the control group(26.7%),the difference was statistically significant(P<0.05).Conclusions Retroperito-neal laparoscopic nephron sparing surgery for T1b renal tumors has less trauma,faster postoperative re-covery,prominent role in improving the renal function of patients,reduce the incidence of complica-tions,and can be widely promoted in clinical practice.

关 键 词：肾肿瘤 肾切除术 腹腔镜检查 

分 类 号：R737.11[医药卫生—肿瘤]