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目的:评估经后腹腔镜与开放肾囊肿去顶减压术的临床价值。方法:回顾性调查四川大学华西医院2004年4月至2008年4月468例经后腹腔镜肾囊肿去顶减压术(A组)和2003年4月至2008年4月121例开放肾囊肿去顶减压术(B组)的临床资料并进行比较,统计分析两种术式术前,术中和术后的数据资料,比如性别、年龄、侧别、囊肿直径、手术时间、术中出血量、术后下床时间、肛门排气时间、引流管拔除时间、术后住院天数、总住院天数等。开放手术均行肋缘下切口,经后腹腔镜均行腰部常规3孔穿刺。结果:所有手术均获成功。A组手术时间53.18±0.95分,术中出血6.28±0.33mL,术后肛门排气时间25.18±0.30h,术后下床时间31.02±0.22h,引流管拔除时间27.15±0.20h,术后住院4.90±0.07d,总住院8.95±0.12d;B组手术时间67.72±1.48分,术中出血51.16±0.77mL,术后肛门排气时间26.91±0.33h,术后下床时间43.31±1.03h,引流管拔除时间29.63±0.79h,术后住院7.88±0.18d,总住院12.5±0.29d。术前两组基线对比无统计差异。A组手术时间、术中出血量、术后下床时间、总住院天数和术后住院天数均优于B组,差异具有统计学意义(P<0.01)。术后肛门排气时间及引流管拔除时间无显著性差异(P>0.05)。结论:后腹腔镜肾囊肿去顶术在手术时间、术中出血量和术后下床时间等方面明显优于开放手术。
Objective: To evaluate the clinical value of retroperitoneal laparoscopic and open renal cyst decompression. Methods: Retrospective investigation of 468 cases of retroperitoneal laparoscopic renal cyst debridement (Group A) from April 2004 to April 2008 in West China Hospital of Sichuan University and 121 open renal cysts from April 2003 to April 2008 The clinical data of the patients who underwent decompression and decompression (group B) were compared and compared. The data of preoperative, intraoperative and postoperative were analyzed statistically, such as gender, age, side, cyst diameter, operation time, intraoperative Bleeding, time to get out of bed, anus exhaust time, drainage tube removal time, postoperative hospitalization days, total hospitalization days and so on. Open surgery under the costal incision, laparoscopic conventional lumbar routine 3-hole puncture. Results: All surgeries were successful. In group A, the operation time was 53.18 ± 0.95 points, the intraoperative bleeding was 6.28 ± 0.33mL, the time of postoperative anal exhaust was 25.18 ± 0.30h, the time of getting out of bed after operation was 31.02 ± 0.22h, the time of drainage tube removal was 27.15 ± 0.20h, 4.90 ± 0.07d, and 8.95 ± 0.12d in hospital. The operation time of group B was 67.72 ± 1.48, the intraoperative bleeding was 51.16 ± 0.77mL, the time of postoperative anal exhaust was 26.91 ± 0.33h and the time to bed was 43.31 ± 1.03h, Drainage tube removal time 29.63 ± 0.79h, postoperative hospital 7.88 ± 0.18d, total hospital 12.5 ± 0.29d. There was no significant difference in baseline between two groups before operation. The operation time, intraoperative blood loss, time to get out of bed, total hospital stay and postoperative hospital stay in group A were significantly better than those in group B (P <0.01). Postoperative anal exhaust time and drainage tube removal time was no significant difference (P> 0.05). Conclusion: Retroperitoneal laparoscopic renal cyst debridement is superior to open surgery in terms of operation time, intraoperative blood loss and time to bed.