一种改良的经后腹腔入路腹腔镜肾癌根治性切除术后取出肾脏的研究  

A modified method of kidney extraction during retroperitoneal laparoscopic radical nephrectomy

作　　者：吉正国[1] 赵美姗 朱一辰[1] 许永德 田野[1] 杨培谦[1] Ji Zhengguo;Zhao Meishan;Zhu Yichen;Xu Yongde;Tian Ye;Yang Peiqian(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《中国医刊》2022年第3期287-290,共4页Chinese Journal of Medicine

基　　金：首都卫生发展科研专项(首发2020-2-1111)。

摘　　要：目的探讨一种改良的经后腹腔入路腹腔镜肾癌根治性切除术后取出肾脏的方法。方法回顾性选取2018年9月至2021年5月首都医科大学附属北京友谊医院采用改良的经后腹腔入路腹腔镜肾癌根治性切除术后取出肾脏的方法进行治疗的90例肾细胞癌患者为改良组,另选取2015年12月至2018年8月采用常规的经后腹腔入路腹腔镜肾癌根治性切除术后取出肾脏的方法进行治疗的83例肾细胞癌患者为传统组。比较分析两组患者的术后恢复情况。结果两组患者的肾脏标本最大横径比较差异无显著性(P>0.05),且两组患者均未发生肿瘤切口种植相关情况。改良组患者的切口长度、术后24h的疼痛评分、术后住院时间均显著短于或低于传统组(P<0.05),术后3个月的切口感觉异常和切口局部肌肉膨出发生率均显著低于传统组(P<0.05)。结论改良的经后腹腔入路腹腔镜肾癌根治性切除术后取出肾脏的方法更有效易行,可显著减小患者的切口,缓解患者的术后疼痛,缩短患者的住院时间,能够促进患者快速康复。Objective To investigate a modified method of kidney extraction during retroperitoneal laparoscopic radical nephrectomy.Method The 90 patients with renal cell carcinoma who underwent the modified method of kidney extraction in Beijing Friendship Hospital,Capital Medical University during retroperitoneal laparoscopic radical nephrectomy from September 2018 to May 2021 were retrospectively selected as modified group.The 83 patients with renal cell carcinoma who underwent the traditional method of kidney removal during retroperitoneal laparoscopic radical nephrectomy from December 2015 to August 2018 were selected as traditional group.The postoperative recovery indexes of the two groups were compared and analyzed.Result There was no significant difference in the maximum transverse diameter of kidney specimens between two groups(P>0.05),and no tumor incisional implantation occurred in two groups.Incision length,24h postoperative pain score and postoperative hospital stay in the modified group were significantly lower than or shorter than those in the traditional group(P<0.05),and the incidence of paresthesia and local muscle swelling in the incision 3 months after surgery were significantly lower than those in the traditional group(P<0.05).Conclusion This modified method of kidney extraction during retroperitoneal laparoscopic radical nephrectomy is effective and feasible,can provide smaller incision,less incision pain,shorter hospital stay,and can promote the rapid recovery of patients.

关 键 词：经后腹腔入路腹腔镜手术 肾癌根治性切除术 改良方式 切口 取出肾脏 

分 类 号：R699.2[医药卫生—泌尿科学]