摘要
目的：探究在保留肾单位手术中3D腹腔镜与传统腹腔镜的疗效对比。方法：对郑州大学第一附属医院泌尿外科2015年2月～2015年6月需进行保留肾单位手术治疗的T1a期肾癌患者按照随机原则进行随机分配,3D腹腔镜手术组36例,同期行传统腹腔镜手术组37例,观察并比较二组在手术时间、术中热缺血时间、术中出血量、术后胃肠道功能恢复时间、引流管留置时间、术后住院时间及术后复发情况（术后随访2～3个月,复查CT）等方面的差异。结果：所有手术均顺利完成,无中转开放,术后病理均未发现切缘阳性,术后随访3个月均未出现复发。3D腹腔镜组和传统腹腔镜组手术时间分别为（83±34）min和（115±40）min,术中热缺血时间分别为（16±7）min和（25±5）min,两组数据比较差异有统计学意义（P〈0.05）,术中出血量分别为（185±40）ml和（189±32）ml,术后胃肠道功能恢复时间（2.0±1.0）d和（2.5±0.5）d,术后拔除引流管时间为（3.6±0.7）d和（3.5±1.0）d,术后住院时间为（6.0±1.5）d和（7.0±1.0）d,两组数据比较差异无统计学意义（P〉0.05）。结论：3D腹腔镜保留肾单位手术是一种安全、可靠的手术方式,与传统腹腔镜方式相比,其具有手术时间短、明显减少热缺血时间等优势,同时3D腹腔镜清晰逼真,明显增加术者操作灵活性,同时手术费用并无明显增加,因此具有较佳的治疗效果和推广意义。
Objective：To compare the efficacy between 3Dlaparoscopy and conventional laparoscopy in nephron-sparing surgery.Method：From February to June 2015 in our deparment,some T1 astage renal cell carcinoma cases were randomly divided into 36 cases of 3Dlaparoscopic group and 37 cases of conventional laparoscopic group in the same period.Then we observed and compared the operation time,intraoperative blood loss,postoperative gastrointestinal function recovery time,drainage tube indwelling time,postoperative hospital stay and postoperative recurrence and other aspects of the difference between two groups.Result：All procedures were successfully completed without conversion to open surgery,and no positive margin was found by pathology.No recurrence was found during the follow-up period of three months after surgery.Operation time of 3Dlaparoscopic group and conventional laparoscopic group were（83 ± 34）and（115 ± 40）min respecitvely and intraoperative warm ischemia time were（16 ± 7）and（25 ± 5）min respectively.There existed significant difference between two groups（P〈0.05）.However,the difference was not significant in the following data between 3Dlaparoscopic group and conventional laparoscopic group（P 〉0.05）：blood loss（185± 40）and（189± 32）ml,postoperative gastrointestinal recovery time（2.0 ± 1.0）and（2.5 ± 0.5）d,postoperative drainage removal time（3.6 ± 0.7）and（3.5 ± 1.0）d,postoperative hospital stay（6.0 ± 1.5）and（7.0 ± 1.0）d respectively.Conclusion：Nephronsparing surgery by 3Dlaparoscopy is a safe and reliable operation mode compared with traditional laparoscopic approach.It produces a shorter operative time,significantly reduced the warm ischemia time and other advantages.The clear and vivid 3Dlaparoscopy significantly increases the surgeon operating flexibility,while cost of 3D laparoscopy are not much more than that of traditional laparoscopic surgery.Therefore,3Dlaparoscopic nephronsparing surgery has a better therapeutic effect and is worth promoting.
出处
《临床泌尿外科杂志》
2016年第5期428-430,共3页
Journal of Clinical Urology
基金
国家自然科学基金资助项目(编号81100464
81200883)
中国博士后科学基金资助项目(编号2012M521410)
郑州市科技创新团队项目(编号13lPCXTD627)
关键词
3D腹腔镜
传统腹腔镜
保留肾单位手术
T1a期肾癌
3Dlaparoscopy
conventional laparoscopy
nephron-sparing surgery
T1astage renal cell carcinoma
