摘要
目的：通过比较侧腹入路、经腹入路和后腹入路三种入路行腹腔镜肾部分切除术（LPN）的优缺点,来研究侧腹入路行LPN治疗肾癌的有效性及安全性。方法：我们回顾分析2011年1月-2013年12月我院行LPN的126例肾肿瘤患者的临床资料,其中42例侧腹入路、38例经腹入路和46例后腹入路（肿瘤直径≤4cm）,比较三种入路行LPN的手术及术后指标。结果：侧腹入路组42例患者手术均获成功,平均手术时间（96±25）min,平均术中出血量（157±83）ml,平均住院时间（7.0±2.5）d,与其他两种入路相比均明显减少（P〈0.05）。侧腹入路组术中没有出现周围脏器损伤等严重并发症,无大出血,无患者输血。术后48h患者下床活动,术后平均住院时间7d。术后随访6-48个月,无一例复发或转移。结论：侧腹入路结合了经腹入路和后腹入路的优点,显露和阻断肾动脉更容易、更清晰;同时在处理肿瘤位于肾脏中上极腹侧面时,操作空间更大、创面缝合更容易。侧腹入路开创了LPN的新入路。
Objective： To compare the efficacy and safety of laparoscopic partial nephrectomy （LPN） among three operation approaches, lateral transperitoneal （LT）, transperitoneal （TP）, and retroperitoneal （RP）. Method：The data were collected from 126 patients including LT （42 cases） , TP （38 cases）, and RP （46 cases） approaches from Jan. 2011 to Dec. 2013 in our hospital. The surgical and early postoperative outcomes and complications were analyzed retrospectively. Result： All 42 operations through LT approaches were successfully performed. The mean operative time was （96±25） min, and the mean blood loss was （157±83） ml. The mean hospital stay was （7.0±2.5） days. The above data showed significantly less than the other two approaches. There were no serious complications or blood transfusion. The average time to ambulation was 48 hours, and mean postoperative hospital stay was 7 days. No recurrence or metastasis was found over follow-up period of 6-48 months. Conclusion： LT approach integrates merits of TP approach and RP approach, especially in the treatment of tumors located in middle and upper pole of kidney of the ventral side. LT approach makes it easier to deal with renal artery land suture the wound, so it creates a promising future of LPN.
出处
《临床泌尿外科杂志》
2015年第8期675-678,共4页
Journal of Clinical Urology
关键词
肾部分切除术
肾肿瘤
侧腹入路
腹腔镜
partial nephrectomy
renal neoplasms
lateral transperitoneal approach
laparoscopy
