摘要
目的探讨不同手术入路的腹腔镜下根治性肾切除术治疗肾癌的疗效。方法依据随机数字表法将96例肾癌患者分为A组和B组,每组48例,A组采取经腹腔入路腹腔镜下根治性肾切除术,B组采取经腹膜后入路腹腔镜下根治性肾切除术。比较两组患者的术后病理类型、病理分期、围手术期相关指标、并发症发生情况及随访结果。结果两组患者的术后病理类型及病理分期比较,差异均无统计学意义(P>0.05)。A组患者的手术时间、术后排气时间均长于B组(P<0.05);两组患者的术中失血量、术后住院时间、输血率、转入重症监护室(ICU)率、并发症总发生率比较,差异均无统计学意义(P>0.05)。随访期内,失访7例,获得随访89例,均无局部复发或死亡病例。两组患者的远处转移率比较,差异无统计学意义(P>0.05)。结论经腹腔入路和经腹膜后入路腹腔镜下根治性肾切除术治疗肾癌均安全、有效,各有其优势,治疗时需结合病理特征、手术难度和术者操作经验,选择合适的手术入路。
Objective To investigate the therapeutic effect of laparoscopic radical nephrectomy for renal carcinoma with different surgical approaches.Method 96 patients with renal carcinoma who underwent laparoscopic radical nephrectomy were enrolled and divided into group A and group B with 48 cases in each group using a random number,group A was treated with transperitoneal approach and group B with retroperitoneal approach.Postoperative pathological type,pathological stage,perioperative indicators,complications and follow-up results were compared between the two groups.Result There was no significant difference in postoperative pathological type and pathological stage between the two groups(P>0.05).The operation time and postoperative exhaust time of group A were significantly longer than those of group B,and the differences were statistically significant(P<0.05).There was no significant difference in the blood loss,postoperative hospital stay,blood transfusion rate,rate of transferring to intensive care unit(ICU)and total incidence of complications between the two groups(P>0.05).During the follow-up period,7 cases were lost.There were 89 cases with no local recurrence or death,no significant difference in the distant metastasis rate between the two groups(P>0.05).Conclusion Both transperitoneal and retroperitoneal laparoscopic radical nephrectomy are safe and effective in the treatment of renal carcinoma,and each has its own advantages.The appropriate surgical approach should be selected according to the pathological characteristics,surgical difficulty and operation experience.
作者
嵇福荣
蔡龙俊
晁流
刘高
张绍崎
张建军
孙永明
方先林
蔡维奇
JI Furong;CAI Longjun;CHAO Liu;LIU Gao;ZHANG Shaoqi;ZHANG Jianjun;SUN Yongming;FANG Xianlin;CAI Weiqi(Department of Urology,Suqian Hospital Affiliated to Xuzhou Medical University/Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group,Suqian 223800,Jiangsu,China)
出处
《癌症进展》
2020年第20期2118-2121,共4页
Oncology Progress
关键词
肾癌
腹腔镜
经腹腔入路
经腹膜后入路
renal carcinoma
laparoscopy
transperitoneal approach
retroperitoneal approach
