摘要
目的评价腹腔镜和后腹腔镜肾癌根治术与开放肾癌根治术的临床价值。方法对32例后腹腔镜、18例腹腔镜肾癌根治术和32例开放肾癌根治术的临床资料进行比较,统计分析三种术式在手术时间、术后住院天数、术中出血量、术后并发症发生率等的差别。结果1例腹腔镜手术因肾静脉撕裂改开放手术,余81例均获成功。3组手术时间分别为(100.5±19.2)m in,(90.3±21.4)m in和(127.2±20.5)m in,术中出血量分别为(40±15)m l、(50±15)m l和(200±30)m l,术后住院天数分别为(5.2±1.3)d、(5.6±1.1)d和(9.1±1.8)d。腹腔镜组、后腹腔镜组均优于开放手术组(P<0.001)。腹腔镜组术中1例肾静脉撕裂;后腹腔镜组无并发症;开放手术组术中发生胸膜损伤2例,术后4例因感染或脂肪液化伤口愈合不佳。结论腹腔镜肾癌根治术在手术时间、术中出血量和术后恢复等方面明显优于开放手术,是一种安全、有效的治疗方法。
Objective To evaluate the clinical value of laparoscopic, retroperitoneal laparoscopic, and open radical nephreetomy. Methods Clinical data of 32 cases of laparoseopie radical nephreetomy （ Laparoseopie Group） , 18 cases of retroperitoneal laparoseopie radical nephreetomy （Retroperitoneal Group）, and 32 cases of open radical nephreetomy （Open Group） were compared in respect of operation time, length of hospitalization after operation, intraoperative hemorrhage volume, and incidence of postoperative complications. Results With exception of 1 case of conversion to open surgery because of ruptured renal vein in the Laparoseopie Group, the operation was successfully completed in all the cases. Of the Laparoseopie Group, Retroperitoneal Group, and Open Group, the operation time was 100.5 ± 19.2 min, 90.3 ± 21.4 min, and 127.2 ± 20.5 min, respectively, the intraoperative hemorrhage volume was 40 ± 15 ml, 50 ± 15 ml, and 200 ± 30 ml, respectively, and the length of postoperative hospitalization was 5.2 ± 1.3 d, 5.6 ± 1.1 d, and 9.1 ± 1.8 d, respectively. Both the Laparoseopie Group and the Retroperitoneal Group were superior to the Open Group （P 〈 0. 001 ）. One case of renal vein rupture was encountered in the Laparoscopic Group and no complications occurred in the Retroperitoneal Group, while in the Open Group there were 2 cases of pleural injury and 4 cases of wound indolence because of infection or fat liquefaction. Conclusions Laparoseopie radical nephreetomy is significantly superior to open radical nephreetomy in respect of operation time, intraoperative hemorrhage volume, and postoperative recovery, being a safe and effective curative method.
出处
《中国微创外科杂志》
CSCD
2006年第8期599-601,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
肾肿瘤
腹腔镜
肾切除术
Renal neoplasm
Laparoseopy
Nephreetomy
