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目的评价腹腔镜下肾癌根治术(LRN)与肾部分切除术(LPN)的临床疗效。方法收集确诊的32例肾癌患者,术前均通过超声、增强CT证实肾脏占位,其中行LRN 20例、LPN 12例。比较两种术式在手术时间、术中出血量、术后肌酐变化值、术后住院天数、手术并发症发生率以及随访1年肿瘤复发转移率的差别。结果 32例手术均顺利完成,无中转开腹及腹腔脏器损伤病例。LRN组平均手术时间(158.3±17.9)min,短于LPN组(189.9±26.2)min(P<0.05),术后肌酐变化值(21.5±6.1)μmol/L,高于LPN组(8.5±3.8)μmol/L(P<0.05),术后住院天数(7.6±1.2)d,短于LPN组(8.7±1.4)d(P<0.05)。而两组在术中出血量、手术并发症、随访1年复发转移率等方面无统计学差异。结论 LPN术式创伤小、恢复快,且对于减少患者术后肾功能损害有显著意义,值得进一步研究。
Objective To evaluate the clinical efficacy of laparoscopic radical nephrectomy (LRN) and partial nephrectomy (LPN). Methods Twenty-two patients with renal cell carcinoma were collected. Twenty-four patients with renal cell carcinoma were confirmed by ultrasound and contrast-enhanced CT before operation. Among them, 20 cases were LRN and 12 cases were LPN. The difference of operation time, intraoperative blood loss, postoperative creatinine change, postoperative hospital stay, the incidence of surgical complications and the recurrence and metastasis rate of tumor after one year of follow-up were compared. Results 32 cases of surgery were successfully completed, no transit laparotomy and abdominal organ injury cases. The mean operative time in the LRN group was (158.3 ± 17.9) min, shorter than that in the LPN group (189.9 ± 26.2) min (P <0.05). The postoperative creatinine change was (21.5 ± 6.1) μmol / L in the LRN group, ) (μmol / L) (P <0.05). The length of postoperative hospital stay (7.6 ± 1.2) d was shorter than that of LPN group (8.7 ± 1.4) d (P <0.05). The two groups in the amount of bleeding, surgical complications, follow-up 1 year recurrence and metastasis rate was no significant difference. Conclusion LPN trauma is small, rapid recovery, and reduce the postoperative renal dysfunction in patients with significant significance, worthy of further study.