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目的与传统开放手术比较,评价后腹腔镜肾癌根治术的手术方法及临床疗效。方法回顾性分析和比较同期94例早期肾癌根治术的临床资料,其中后腹腔镜肾癌根治术(A组)55例,开放性肾癌根治术(B组)39例,对手术时间、术中出血量、术后并发症及术后恢复情况等进行比较。A组患者肿瘤大小1.8～6.5(平均4.9)cm,B组患者肿瘤大小3.0～6.8(平均5.5)cm。患者术前均行B超、IVP、CT或MRI等检查明确诊断,临床分期均为:T1N0M0～T2 bN0M0。结果后腹腔镜组和开放手术组手术时间分别为(146±10.5)和(121±12.4)min(P>0.05),术中出血量分别为(80±12)和(210±17)ml(P<0.01),术后住院天数分别为(5.1±1.2)和(8.4±1.6)天(P<0.05)。两组病人术中术后均未发生严重并发症,随访6～18个月未见肿瘤复发及转移。结论后腹腔镜肾癌根治术与开放手术相比较,具有创伤小、并发症少、恢复快等优点,对于局限性肾癌的肿瘤控制与开放手术相当,值得临床推广应用。
Objective To compare the operation of traditional laparoscopic radical nephrectomy with traditional open surgery and to evaluate its curative effect. Methods The clinical data of 94 cases of early radical nephrectomy were retrospectively analyzed and compared. Among them, 55 cases were treated with retroperitoneal laparoscopic radical nephrectomy (group A) and 39 cases were treated with open nephrectomy (group B). The operative time, Blood loss, postoperative complications and postoperative recovery were compared. Patients in group A had a tumor size of 1.8 to 6.5 (mean, 4.9) cm. Patients in group B had a tumor size of 3.0 to 6.8 (mean, 5.5) cm. Patients underwent preoperative ultrasound B, IVP, CT or MRI examination confirmed the diagnosis, clinical stage were: T1N0M0 ~ T2 bN0M0. Results The operative time of the laparoscopic group and the open surgery group were (146 ± 10.5) and (121 ± 12.4) min (P> 0.05), and the intraoperative bleeding was (80 ± 12) and (210 ± 17) ml P <0.01). The days after hospitalization were (5.1 ± 1.2) days and (8.4 ± 1.6) days respectively (P <0.05). No severe complications occurred in the two groups during operation, and no tumor recurrence and metastasis were observed at 6-18 months follow-up. Conclusions Retroperitoneal laparoscopic radical nephrectomy compared with open surgery has the advantages of less trauma, fewer complications and faster recovery. It is worthy of clinical application for the control of open renal neoplasms.