摘要
目的探讨后腹腔镜联合经尿道电切镜与开放手术处理输尿管末端,治疗上尿路肿瘤疗效,为上尿路肿瘤手术治疗提供依据。方法收集2011年11月至2014年11月青海红十字医院治疗的85例尿路恶性肿瘤患者的临床资料,其中采用传统开放手术40例设为对照组;采用后腹腔镜联合经尿道电切镜45例设为观察组。比较两组患者的手术时间、术中出血量、引流量以及住院时间等指标;采用视觉模拟评分法(VAS)评价术后1 h、12 h、24 h、48 h疼痛程度;随访3年记录两组患者局部复发率、远处转移率、生存率、无瘤生存率以及病死率。结果观察组手术时间、术中出血量、术后胃肠功能恢复时间、住院时间均低于对照组(均P<0.05)。两组拔除引流管,时间、引流量差异无统计学意义(P>0.05)。观察组术后1 h、12 h、24 h的VAS评分低于对照组(P<0.05)。两组3年局部复发率、远处转移率、生存率、无瘤生存率以及病死率,差异无统计学意义(均P>0.05)。结论后腹腔镜联合经尿道电切镜治疗上尿路移行细胞癌,既能达到微创治疗要求,又能完整切除癌肿。手术安全有效,符合肿瘤根治外科学原则。
Objective To investigate the long-term curative effect of transurethral resection and open surgery of operating ureteral orifice in the treatment of upper urinary tract tumors and provide theoretical basis for the surgical treatment of urinary tract tumors. Methods The clinical data of 85 patients with urinary tract malignant tumor treated in our hospital from November 2011 to November 2014 were retrospectively analyzed. Forty patients treated with conventional open excision of ureteral orifice were selected as the control group, and 45 patients underwent retroperitoneal laparoscopic transurethral resection of ureteral orifice were selected as the observation group. The operation and hospitalization indexes such as operation time, intraoperative blood loss, drainage and hospitalization time were compared. Visual analogue scale （VAS） was used to evaluate the pain levels at 1 h, 12 h, 24 h and 48 h after operation. The local recurrence rate, distant metastasis rate, survival rate, tumor-free survival rate and mortality rate were recorded in both groups in the postoperative 3-year-follow- up. Results The operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time and hospital stay in the observation group were significantly lower than those in the control group （all P〈0. 05 ）. There was no significant difference in drainage removal time and drainage volume between the two groups （P〉 0. 05 ）. The VAS score of the observation group was significantly lower than that of the control group at 1 h, 12 h, and 24 h after operation, the difference was statistically significant （P〈0. 05 ）. The local recurrence rate,distant metastasis rate, survival rate, disease-free survival rate and mortality rate between the two groups within 3 years were not statistically significant （all P〉0. 05 ）. Conclusions Compared with open surgery, transurethral resection of ureteral orifice in the treatment of upper urinary tract tumors has no significant difference in terms of survival rate, disease-free survival rate and other long-term effects, but the latter one has the advantages of less trauma, less postoperative pain, shorter hospital stay, and minimally invasive.
出处
《中国肿瘤外科杂志》
CAS
2018年第4期257-259,264,共4页
Chinese Journal of Surgical Oncology
关键词
上尿路肿瘤
经尿道电切
开放手术
输尿管末端
Upper urinary tract tumor
Transurethral resection
Open surgery
Operating ureteral orifice
