摘要
目的通过回顾性研究评估经过后腹腔镜根治性肾输尿管切除术治疗的肾盂癌及上段输尿管癌患者,比较术中两种不同输尿管末端处理方式(下腹部小切口与经尿道电切)的临床疗效、安全性及预后。方法选取2012年1月至2022年12月期间于新疆医科大学第一附属医院术后病理诊断为肾盂癌或上段输尿管癌并行肾输尿管切除术治疗的108例患者资料,根据术中输尿管末端处理方式的不同,将患者分为下腹部小切口组(开放组n=58)与经尿道电切组(电切组n=50),其中开放组患者行后腹腔镜肾输尿管切除联合下腹部小切口输尿管末端切除术,电切组患者行后腹腔镜肾输尿管切除联合经尿道电切输尿管末端切除术。比较两组手术出血量、术后住院持续时间、复发情况、并发症状况。结果开放组手术时间(171±54)min,尿道组手术时间(141±37)min、两组手术持续时间差异有统计学意义(P<0.05)。术中出血量、术后的住院持续时间、复发率、术后并发症发生率差异均无统计学意义(P>0.05)。结论无论是治疗肾盂癌还是上段输尿管癌,使用两种输尿管末端治疗技术都是安全有效的,经尿道电切术手术时间更短,两种方式均可选择。
Objective To evaluate the clinical efficacy,safety and prognosis of patients with renal pelvis carcinoma and upper ureteral carcinoma treated by retroperitoneal laparoscopic radical nephroureterectomy.Whether there is a significant difference in the clinical efficacy,safety and prognosis of two different methods of ureteral terminal treatment(lower abdominal small incision and transurethral resection).Methods Analysis of the data from 108 patients with renal pelvis carcinoma or upper ureteral carcinoma,treated by nephroureterectomy at the first affiliated Hospital of Xinjiang Medical University from January 2012 to December 2022 was conducted.according to the different treatment of the end of the ureter,the patients were divided into two groups:lower abdominal small incision group(open group,n=58)and transurethral resection group(transurethral resection group,n=50).Patients in the open group underwent a retroperitoneal laparoscopic nephroureterectomy,along with a lower abdominal small incision ureterectomy,and those in the urethra group underwent a retroperitoneal laparoscopic nephroureterectomy and transurethral resection of the ureter.To gain a better understanding of the clinical data of the two groups,including basic data,operation time,intraoperative blood loss,postoperative hospital stay,and postoperative outcomes,a collection of data was made.recurrence,recurrence location and complications,a conclusion was drawn by statistical analysis.Results The open group’s average operation time was(171±54)min,while the urethra group’s was(141±37)min.However,no significant difference in intraoperative blood loss,postoperative hospital stay,recurrence rate,or postoperative complications was observed between the two groups.Conclusion Consequently,it is concluded that both methods of ureteral terminal treatment for renal pelvis and upper ureteral carcinoma are safe and dependable,with the transurethral resection operation time being shorter.at the same time,it did not increase the risk of postoperative recurrence a
作者
韩峰
董国帆
王一涵
王文光
HAN Feng;DONG Guofan;WANG Yihan;WANG Wenguang(Department of Urology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shanxi,China)
出处
《中国现代医生》
2024年第20期90-93,98,共5页
China Modern Doctor
关键词
上尿路尿路上皮癌
后腹腔镜根治性肾输尿管切除术
输尿管末端处理方式
Upper urinary tract urothelial carcinoma
Retroperitoneal laparoscopic radical nephroureterectomy
Ureteral terminal management