开放与腹腔镜手术治疗常见原发性腹膜后良性肿瘤的疗效比较  

Comparison of Therapeutic Effects of Open Surgery and Laparoscopic Surgery for Common Primary Retroperitoneal Benign Tumors

作　　者：陈小兵 肖萌萌 苗成利[1] 罗成华[1] Chen Xiaobing;Xiao Mengmeng;Miao Chengli(Department of Retroperitoneal Tumor Surgery,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院腹膜后肿瘤外科,北京102206

出　　处：《中国微创外科杂志》2023年第9期676-679,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学国际医院研究基金(YN2021ZD04);北京大学国际医院研究基金(YN2022QN09)。

摘　　要：目的探讨常见原发性腹膜后良性肿瘤的不同手术方式的疗效。方法回顾性分析我科2015年1月~2022年10月50例常见腹膜后良性肿瘤的临床资料,根据患者意愿选择开放(开放组,n=30)或腹腔镜手术(腔镜组,n=20),比较术中出血量、手术时间、术后禁食时间、拔管时间、住院时间和术后并发症情况。结果开放组术中出血量200.0(87.5,525.0)ml,显著多于腔镜组75.0(27.5,300.0)ml(Z=-2.081,P=0.037);术后禁食时间3.0(1.0,3.2)d,显著长于腔镜组1.0(1.0,2.0)d(Z=-2.848,P=0.004)。开放组和腔镜组手术时间分别为(131.0±45.9)、(135.4±58.5)min,术后拔管时间分别为(8.7±4.1)、(7.5±4.5)d,术后住院时间分别为(11.2±4.0)、(9.8±3.5)d,差异均无显著性(P>0.05)。开放组和腔镜组各发生1例术后并发症,对症治疗后好转。48例随访2~88个月,中位随访54个月,无复发。结论在腹膜后良性肿瘤的外科治疗中,腔镜手术较开放手术出血量少,术后胃肠功能恢复快,2种手术方式术后均可长期生存。Objective To compare therapeutic effects of different surgical methods for common primary retroperitoneal benign tumors.Methods Clinical data of 50 patients diagnosed as having primary retroperitoneal benign tumors in our hospital from January 2015 to October 2022 were retrospectively analyzed.According to patients’wishes,they were selected to open(open group,n=30)or laparoscopic(laparoscopic group,n=20)surgery.The amount of intraoperative bleeding,operation time,postoperative fasting time,extubation time,postoperative hospital stay and postoperative complications were compared.Results The median blood loss in the open group[200.0(87.5,525.0)ml]was significantly higher than that in the laparoscopic group[75.0(27.5,300.0)ml,Z=-2.081,P=0.037].The median postoperative fasting time was 3.0(1.0,3.2)d in the open group and 1.0(1.0,2.0)d in the laparoscopic group,with a statistically significant difference(Z=-2.848,P=0.004).For the open group and the laparoscopic group,the operation time was(131.0±45.9)min and(135.4±58.5)min,the extubation time was(8.7±4.1)d and(7.5±4.5)d,and the postoperative hospital stay was(11.2±4.0)d and(9.8±3.5)d,respectively,and there were no significant differences between the two groups(P>0.05).One case of postoperative complication happened in each of the open group and the laparoscopic group,and both of them were improved after symptomatic treatment.During a median of follow-ups for 54 months(range,2-88 months)in 48 patients,no recurrence was found.Conclusions In the surgical treatment of retroperitoneal benign tumors,laparoscopic surgery has less bleeding and faster recovery of gastrointestinal function than open surgery.Both methods can achieve long-term survival after surgery.

关 键 词：腹膜后肿瘤 开放手术 腹腔镜手术 

分 类 号：R735.4[医药卫生—肿瘤]