摘要
目的评价腹腔镜肾盂癌根治术并总结经验。方法2000年8月～2006年5月行腹腔镜手术治疗19例肾盂癌(含8例手辅式),其中输尿管末端经尿道切除17例,经手辅切口切除2例。同时期行开放性肾盂癌根治术30例作对照分析。结果腔镜组与开放组手术时间差异无显著(P=0.59),腔镜组术中出血量、术后肠功能恢复时间、引流管拔除时间、下床活动时间及住院时间显著少于开放组(P<0.01),腔镜组术中、术后未发生明显并发症,开放组1例出现术后切口感染。随访1～61个月,腔镜组1例肺部转移,开放组1例出现肺部转移,1例腹膜后局部复发,1例发生膀胱癌。结论后腹腔镜结合电切镜行肾盂癌根治术具有创伤小、恢复快的优点,并不增加肿瘤种植的风险,有望取代传统开放手术。
[Objective] To evaluate the laparoscopie nephrouretereetomy in renal pelvic carcinoma and summarize our experiences in the surgery. [Methods] From Augest 2000 to May 2006, laparoscopic nephroureterectomy was performed in 19 cases （8 underwent hand-assisted laparoscopic surgery）, Transurethral resection of the ureteral orifice with bladder cuff was performed in 17 cases, and in the other 2 cases, the ureteral orifice was resected in traditional way through the incision for hand-assisted laparoscopic surgery. In the same period, open radical nephroureterectomy was performed in 30 cases as control. [Results] There was no significant difference between laparoscopic group and open group in operative time （P =0.59）. The amount of blood loss during operation and the time of intestinal function recovery, ambulation, drainage tube removed and hospitolization stay after Operation in laparoscopic group were significantly less than open group （P 〈0.01）. Incision infection occurred in 1 case of open group, and no significant perioperative complications presented in laparoscopic group. During the follow-up of 1-61 months, 1 case was found lung metastasis in laparoscopic group; In open group, 1 case was found lung metastasis, 1 case was found recurrence and 1 case was found suffer from bladder tumor. [Conclusions] Retroperitoneal laparoscopic nephroureterectomy combined with resectoscope in the treatment of renal pelvic carcinoma is feasible, effective and minimal-invasive.
出处
《中国内镜杂志》
CSCD
北大核心
2007年第6期577-579,共3页
China Journal of Endoscopy
关键词
腹腔镜
肾输尿管全切除术
肾孟癌
laparoscopy
nephroureterectomy
renal pelvic carcinoma
