摘要
目的探讨后腹腔镜根治性切除术(retroperitoneal laparoscopic radical nephrectomy,RLRN)治疗肾癌患者的疗效,并分析影响患者术后复发的相关因素。方法选取2017年6月-2020年3月北京市顺义区医院收治的肾癌患者106例,随机分为对照组和观察组,每组53例。对照组采用传统开放性肾癌根治性切除术(open radical nephrectomy,ORN),观察组采用RLRN。记录两组手术时间、术中出血量、术后肠功能恢复时间、引流管留置时间、住院时间等资料。测定两组血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、肾小球滤过率(glomerular filtration rate,GFR)水平。术后1年随访,根据是否复发分为复发组和未复发组两个亚组。结果观察组手术时间、术中出血量、术后肠功能恢复时间、引流管留置时间、住院时间均低于对照组(P<0.05)。两组术后BUN水平均高于术前,Scr、GFR水平均低于术前(P<0.05)。观察组BUN水平低于对照组,Scr、GFR水平均高于对照组(P<0.05)。卡方检验结果显示,年龄、吸烟史、肿瘤直径、TNM分期、手术方法、术后免疫治疗与术后肾癌复发有关(P<0.05)。二分类Logistic分析显示,年龄、肿瘤直径、TNM分期、手术方法、术后免疫治疗是术后肾癌复发的独立影响因素(P<0.05)。结论 RLRN治疗肾癌患者手术时间短、创伤小、术后恢复快,且能够有效缓解患者肾功能损伤情况,值得推广。
Objective To investigate the efficacy of retroperitoneal laparoscopic radical resection(RLRN) in the treatment of renal carcinoma, and to analyze the related factors of postoperative recurrence. Methods The total of 106 renal cell carcinoma patients treated in our hospital from June 2017 to March 2020 were randomly divided into the control group(n=53) and the observation group(n=53). The control group was treated with traditional open radical nephrectomy(ORN), and the observation group was treated with RLRN. Operation time, intraoperative blood loss, postoperative bowel function recovery time, drainage tube retention time, and hospital stay were recorded in both groups. The levels of blood urea nitrogen(BUN), serum creatinine(Scr), and glomerular filtration rate(GFR) were measured in both groups.After one year of follow-up, 106 patients were divided into two subgroups: relapse group and non-relapse group. Results The operation time, intraoperative blood loss, postoperative bowel function recovery time, drainage tube retention time, and hospitalization time of the observation group were all lower than those in the control group(P<0.05). The level of BUN after operation in both groups was higher than that before operation, and the level of Scr and GFR was lower than those before operation(P<0.05). The BUN level of the observation group was lower than that in the control group, and the levels of Scr and GFR were higher than those in the control group(P<0.05). Chi-square test showed that age, smoking history, tumor diameter, TNM stage, surgical method, and postoperative immunotherapy were associated with postoperative renal carcinoma recurrence(P<0.05). The Binary logistic analysis showed that age, tumor diameter,TNM stage, surgical method, and postoperative immunotherapy were independent influencing factors for postoperative renal carcinoma recurrence(P<0.05). Conclusion The patients received RLRN has short operation time, less trauma,fast recovery after operation, and can effectively relieve the patients renal func
作者
赵跃华
杨金强
张春雨
李森
宋谣
ZHAO Yuehua;YANG Jinqiang;ZHANG Chunyu;LI Sen;SONG Yao(Beijing Shunyi Hospital,Beijing 101300,China)
出处
《转化医学杂志》
2021年第6期378-381,共4页
Translational Medicine Journal
关键词
肾肿瘤
后腹腔镜根治性切除术
疗效
肾功能
复发
Renal cell carcinoma
Retroperitoneal laparoscopic radical nephrectomy
Efficacy
Renal function
Recurrence
