后腹腔镜下肾部分切除术与肾根治性切除术治疗T1b期肾癌的疗效比较  

Analysis of curative effects between retroperitoneal laparoscopic partial nephrectomy and radical nephrectomy for stage T1b renal cell carcinoma

作　　者：陶美满[1] 马克钧[1] 郭涛[1] 周留正[1] 潘鹏[1] Tao Meiman;Ma Kejun;Guo Tao;Zhou Liuzheng;Pan Peng(Department of Urology,Affiliated Hospital of Jiangsu Universiy,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院泌尿外科,镇江212001

出　　处：《国际泌尿系统杂志》2022年第6期1006-1010,共5页International Journal of Urology and Nephrology

基　　金：江苏大学附属医院博士基金项目(jdfyRC2020008)。

摘　　要：目的比较后腹腔镜下肾部分切除术与肾根治性切除术治疗T1b期肾癌的近远期疗效。方法回顾性分析2013年1月至2017年1月在本院行后腹腔镜手术治疗的102例T1b期肾癌患者的临床资料。根据手术方式分为肾部分切除术组(49例)和肾根治性切除术组(53例)。比较两组的手术时间、住院时间、术后引流管留置时间、术中出血量及围手术期并发症发生情况;术后定期随访,比较术后血肌酐(Scr)、尿素氮(BUN)水平及局部复发、远处转移等情况。结果肾部分切除术组的手术时间长于肾根治性切除术组,术中出血量少于肾根治性切除术组,差异均有统计学意义(均P<0.001);两组患者的术后引流管拔出时间、术后住院时间及围手术期并发症发生率比较,差异均无统计学意义(均P>0.05)。两组患者的术前Scr和BUN水平比较,差异均无统计学意义(均P>0.05);术后1 d,两组患者的BUN和Scr水平均较术前升高(均P<0.05),但两组患者的Scr和BUN水平比较,组间差异均无统计学意义(均P>0.05)。术后6、12个月,肾部分切除术组的Scr、BUN水平均低于肾根治性切除术组,差异均有统计学意义(均P<0.05)。术后两组患者的局部复发、远处转移情况比较,差异均无统计学意义(1.9%vs.4.1%、1.9%vs.2.0%,均P>0.05);两组的3年无瘤生存率比较,差异无统计学意义[50例(94.3%)vs.47例(95.9%),P>0.05]。结论后腹腔镜下肾部分切除术与肾根治性切除术治疗T1b期肾癌的短期疗效、局部复发及远处转移情况相似,但后腹腔镜下肾部分切除术后对患者的肾功能影响更小。Objective To compare the near and long-term outcomes of retroperitoneal laparoscopic partial nephrectomy and radical nephrectomy for stage T1b renal cell carcinoma.Methods The clinical data of 102 patients with T1b renal cell carcinoma who underwent retroperitoneal laparoscopic surgery in our hospital from January 2013 to January 2017 were retrospectively analyzed.The patients were divided into partial nephrectomy group(49 cases)and radical nephrectomy group(53 cases).The operation time,hospital stay,postoperative drainage tube indwelling time,intraoperative blood loss and perioperative complications were compared between the two groups.The levels of serum creatinine(Scr),blood urea nitrogen(BUN),local recurrence and distant metastasis were compared.Results The operation time of partial nephrectomy group was longer than that of radical nephrectomy group,and the intraoperative blood loss was less than that of radical nephrectomy group,and the differences were statistically significant(all P<0.001).There were no significant differences in postoperative drainage tube extraction time,postoperative hospital stay and perioperative complication rate between the two groups(all P>0.05).There was no significant difference in preoperative Scr and BUN levels between the two groups(all P>0.05).At 1 day after operation,the levels of BUN and Scr in the two groups were higher than those before operation(all P<0.05),but there was no significant difference in the levels of Scr and BUN between the two groups(all P>0.05).At 6 and 12 months after operation,the levels of Scr and BUN in the partial nephrectomy group were lower than those in the radical nephrectomy group,and the differences were statistically significant(all P<0.05).There was no significant difference in local recurrence and distant metastasis between the two groups after operation(all P>0.05).There was no significant difference in the 3-year disease-free survival rate between the two groups[50 cases(94.3%)vs.47 cases(95.9%),P>0.05].Conclusions Retroperitoneal laparosco

关 键 词：肾肿瘤 腹腔镜检查 肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]