摘要
目的探究经腹膜后入路腹腔镜手术治疗大体积肾癌的临床效果。方法方便选择2013年1月—2018年12月该院收治的158例大体积肾癌患者进行研究,均接受腹腔镜根治术治疗,根据其手术入路不同分为两组,其中,对照组(n=81)经腹腔入路施术,观察组(n=77)经腹膜后入路施术,比较两组治疗总有效率、手术情况、术后并发症发生率、手术前后机体炎症反应变化及随访情况。结果观察组治疗总有效率93.51%,与对照组的93.83%相比,差异无统计学意义(χ^2=0.000,P=1.000)。观察组患者手术时间、术后首次肛门排气时间、下床活动时间、术后引流管留置时间和住院时间均显著短于对照组,差异有统计学意义(P<0.05)。观察组患者术中出血量、术后总引流量均较对照组明显减少,差异有统计学意义(P<0.05)。观察组术后并发症总发生率5.19%,对照组为8.64%,组间差异无统计学意义(P>0.05)。术前,两组WBC计数、CRP、IL-6检测值比较,差异无统计学意义(P>0.05),术后,两组上述3项炎症指标均较术前明显升高,但观察组较对照组明显降低,差异有统计学意义(P<0.05)。结论经腹膜后入路腹腔镜手术治疗大体积肾癌具有疗效好、创伤少、引流量少、术后恢复快等优势,而且对机体炎症反应影响较少,更有利于缩短患者康复进程,值得推广应用。
Objective To explore the clinical effect of retroperitoneal approach through laparoscopic surgery in the treatment of large-volume renal cell carcinoma.Methods 158 patients with large-volume renal cell carcinoma admitted to the hospital from January 2013 to December 2018 were selected for the study.They all received laparoscopic radical resection.They were divided into two groups according to their different surgical approaches.Among them,the control group(n=81)was performed transperitoneal approach,and the observation group(n=77)was performed retroperitoneal approach.The operation conditions,postoperative complications,changes in body inflammation before and after the operation and follow-up were compared between the two groups.Results The total effective rate of treatment in the observation group was 93.51%,compared with 93.83%in the control group,the difference was not statistically significant(χ^2=0.000,P=1.000).The operation time,the first postoperative anus exhaust time,the time to get out of bed,the postoperative drainage tube indwelling time and the hospital stay in the observation group were significantly shorter than those in the control group,the difference was statistically significant(P<0.05).The intraoperative blood loss and postoperative total drainage in the observation group were significantly reduced compared with the control group,the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 5.19%,and that of the control group was 8.64%.There was no statistically significant difference between the groups(P>0.05).Before operation,the WBC count,CRP and IL-6 detection values of the two groups were not statistically different(P>0.05).After the operation,the above three inflammatory indexes in the two groups were significantly higher than those before the operation,but the observation group was significantly reduced compared with the control group,the difference was statistically significant(P<0.05).Conclusion Laparoscopic surge
作者
郑怀颖
卢庆
林益山
周凯
陈剑晖
谢若云
江玮
ZHENG Huai-ying;LU Qing;LIN Yi-shan;ZHOU Kai;CHEN Jian-hui;XIE Ruo-yun;JIANG Wei(Department of Urology,Union Hospital,Fujian Medical University,Fuzhou,Fujian Province,350001 China)
出处
《中外医疗》
2020年第33期81-84,共4页
China & Foreign Medical Treatment
关键词
大体积肾癌
腹腔镜手术
经腹膜后入路
Large-volume renal cell carcinoma
Laparoscopic surgery
Retroperitoneal approach
