经后腹腔入路与经腹腔入路腹腔镜肾癌根治性切除术的疗效比较  

Comparison of the efficacy of retroperitoneal approach and transperitoneal approach laparoscopic radical nephrectomy for renal cancer

作　　者：宋瑞彬 董山峰 郑保良 SONG Ruibin;DONG Shanfeng;ZHENG Baoliang(Department of Urology,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454000,He’nan,China)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院泌尿外科,河南焦作4540000

出　　处：《癌症进展》2024年第18期2081-2084,共4页Oncology Progress

摘　　要：目的比较经后腹腔入路与经腹腔入路腹腔镜肾癌根治性切除术的疗效。方法选取82例腹腔镜肾癌根治性切除术患者,根据手术入路途径不同分为经后腹腔入路组(n=43)和经腹腔入路组(n=39)。比较两组患者的手术相关指标、疼痛程度[视觉模拟评分法(VAS)]、临床疗效、并发症发生情况和复发情况。结果两组患者的手术时间、术中出血量、下床活动时间比较,差异均无统计学意义(P﹥0.05)。经后腹腔入路组患者住院时间、肠道功能恢复时间、术后引流时间、术后排气时间均短于经腹腔入路组,差异均有统计学意义(P﹤0.05)。术后12、24、48 h,经后腹腔入路组患者VAS评分均低于经腹腔入路组,差异均有统计学意义(P﹤0.05)。两组患者治疗总有效率、并发症总发生率、术后6个月复发率比较,差异均无统计学意义(P﹥0.05)。结论经后腹腔入路与经腹腔入路腹腔镜肾癌根治性切除术的疗效和安全性相当,但经后腹腔入路能够改善手术相关指标,减轻患者术后疼痛。Objective To compare the efficacy of retroperitoneal approach and transperitoneal approach laparoscopic radical nephrectomy for renal cancer.Method A total of 82 patients who underwent laparoscopic radical nephrectomy for renal cancer were selected and divided into retroperitoneal approach group(n=43)and transperitoneal approach group(n=39)based on different surgical approaches.The surgical related indicators,pain degree[visual analogue scale(VAS)],clinical efficacy,incidence of complications and recurrence were compared between the two groups.Result There were no statistically significant differences in the surgical time,intraoperative blood loss,and getting out of bed time between the two groups(P>0.05).The hospitalization time,intestinal function recovery time,postoperative drainage time,and postoperative exhaust time in the retroperitoneal approach group were shorter than those in the transperitoneal approach group,and the differences were statistically significant(P<0.05).At 12,24,and 48 h postoperatively,the VAS scores in the retroperitoneal approach group were lower than those in the transperitoneal approach group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the total effective rate,total incidence of complications,and 6 months postoperative recurrence rate between the two groups(P>0.05).Conclusion The efficacy and safety of laparoscopic radical nephrectomy via retroperitoneal approach are comparable to those via transperitoneal approach,but retroperitoneal approach can improve surgical related indicators and alleviate postoperative pain in patients.

关 键 词：经后腹腔入路 经腹腔入路 腹腔镜肾癌根治性切除术 疗效 

分 类 号：R737.11[医药卫生—肿瘤]