完全后腹腔镜下肾输尿管全长切除术治疗上尿路尿路上皮癌的效果  

Effect of complete retroperitoneoscopic nephroureterectomy for upper tract urothelial epithelial carcinoma

作　　者：张先云 王苏贵 姜福金 马松 王磊 力威 ZHANG Xianyun;WANG Sugui;JIANG Fujin;MA Song;WANG Lei;LI Wei(Department of Urology,the Affiliated Huai'an Hospital of Xuzhou Medical University,Huai'an Second People's Hospital,Jiangsu Province,Huai'an 223002,China)

机构地区：[1]徐州医科大学附属淮安医院、淮安市第二人民医院泌尿外科,江苏淮安223002

出　　处：《中国当代医药》2023年第8期71-74,79,共5页China Modern Medicine

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助项目(WSW-218)。

摘　　要：目的探讨完全后腹腔镜下肾输尿管全长切除术治疗上尿路尿路上皮癌的疗效及安全性。方法回顾性分析2016年1月至2022年6月淮安市第二人民医院收治的53例上尿路尿路上皮癌患者的临床资料,按照手术方式不同分为观察组(25例)和对照组(28例),观察组采用完全后腹腔镜下肾输尿管全长切除术,对照组采用后腹腔镜联合下腹部斜切口手术,比较两组患者的临床疗效。结果观察组患者的平均手术时间、引流管拔除时间、术后肠蠕动恢复时间及术后住院时间均短于对照组患者,观察组术中平均出血量及术后引流管引流量均少于对照组,差异有统计学意义(P<0.05)。两组患者的总术后并发症发生率及术后总复发率之间比较,差异无统计学意义(P>0.05)。结论相较于传统的腹腔镜联合下腹部斜切口手术方式,完全后腹腔镜下肾输尿管全长切除术更微创、术后恢复更快。Objective To investigate the efficacy and safety of complete retroperitoneoscopic nephroureterectomy for upper tract urothelial carcinoma.Methods The clinical data of 53 patients with upper tract urothelial carcinoma admitted to Huai'an Second People's Hospital from January 2016 to June 2022 were retrospectively analyzed.They were divided into the observation group(n=25)and the control group(n=28)according to the different surgical methods.The observation group was treated with complete retroperitoneoscopic nephroureterectomy,and the control group was treated with retroperitoneal laparoscopic combined with abdominal oblique incision surgery.The clinical effects of the two groups were analyzed and compared.Results The mean operation time,drainage time,recovery time of postoperative intestinal peristalsis and postoperative hospital stay of patients in the observation group were shorter than those in the control group,and the median blood loss and postoperative drainage volume of patients in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences between the two groups in the total postoperative complication rate and the total postoperative recurrence rate(P>0.05).Conclusion Compared with the traditional laparoscopic surgery combined with oblique abdominal incision,complete retroperitoneoscopic nephroureterectomy is more minimally invasive and has faster postoperative recovery.

关 键 词：上尿路尿路上皮癌 肾输尿管全长切除术 后腹腔镜 效果 

分 类 号：R737.1[医药卫生—肿瘤]