摘要
目的探讨层面外科在经腹入路腹腔镜下大体积肾癌根治术中的应用效果。方法选取我院2014年1月～2018年11月收治的56例大体积肾癌作为研究对象。按随机数字表法将其分为A组(28例)与B组(28例)。A组施行开放经腹腔入路肾癌根治术,B组施行层面外科经腹入路腹腔镜下肾癌根治术。比较两组患者的术中出血量、手术时间、术后住院时间、术后下床活动时间、术后肠道功能恢复时间、视觉模拟评分法(VAS)疼痛评分及术后拔除腹腔引流管时间、输血率及并发症总发生率等。结果 B组患者的术中出血量少于A组,手术时间、术后住院时间、术后下床活动时间、术后肠道功能恢复时间及术后拔除腹腔引流管时间短于A组,VAS评分低于A组,差异均有统计学意义(P<0.001);B组患者的输血率、术中并发症和术后并发症总发生率低于A组,满意度高于A组,差异均有统计学意义(P<0.05)。结论层面外科在经腹入路腹腔镜下大体积肾癌根治术中的应用是安全有效的,术中循天然无血管、少脂肪和多层次的解剖外科层面进行游离,出血少,输血率低,术中和术后并发症少,以及术后恢复快、患者满意度高,值得临床推广和应用。
Objective To investigate the application effect of trans-interfascial plane surgery in radical nephrectomy for large volume renal carcinoma under transabdominal laparoscope.Methods From January 2014 to November 2018,56 patients with large volume renal carcinoma treated in our hospital were selected as the study subjects.They were divided into group A(28 cases)and group B(28 cases)by the random number table method.Group A was given open transperitoneal radical nephrectomy for renal cancer,while group B was given trans-inaterfascial plane surgery for laparoscopic radical nephrectomy by transabdominal approach.The intraoperative blood loss,operation time,postoperative hospital stay,time to get out of bed after operation,postoperative intestinal function recovery time,visual analogue scale(VAS)pain score,postoperative removal of abdominal drainage tube,blood transfusion rate and total incidence of complication were compared in patients between the two groups.Results The intraoperative blood loss in group B were less than that in group A,and the operative time,postoperative hospital stay,time to get out of bed after operation,postoperative intestinal function recovery time,and postoperative removal of abdominal drainage tube in group B were shorter than those of group A,and VAS score was lower than that in group A,and the differences were statistically significant between the two groups(P<0.001).The blood transfusion rate,the total incidence of intraoperative complications and postoperative complications in group B were lower than those in group A,and the satisfaction degree was higher than that in group A,with statistical significances(P<0.05).Conclusion The application of trans-inaterfascial plane surgery in large volume renal carcinoma with laparoscopic radical nephrectomy by transabdominal approach is safe and effective.It is dissociated by following natural avascular,less fat and multi-level anatomical surgical layers during the operation,which has less bleeding,low blood transfusion rate,few intraoperative and p
作者
朱陈辉
黄长青
黄海文
高绍青
蔡智仁
ZHU Chen-hui;HUANG Chang-qing;HUANG Hai-wen;GAO Shao-qing;CAI Zhi-ren(Department of Urology Surgery,Zhanjiang Central People's Hospital,Guangdong Province,Zhanjiang 524045,China)
出处
《中国当代医药》
2019年第10期12-16,共5页
China Modern Medicine
基金
广东省湛江市非资助科技攻关计划项目(2018B01147)
关键词
层面外科
经腹入路
大体积肾癌
腹腔镜根治性手术
应用效果
Trans-interfascial plane surgery
Transabdominal approach
Large volume renal carcinoma
Laparoscopic radical surgery
Application effect
