摘要
目的对比与分析后腹腔镜下肾切除术治疗肾肿瘤的效果。方法采用回顾性、总结研究方法,以肾肿瘤患者78例作为研究对象,根据治疗方法的不同分为观察组40例与对照组38例,观察组给予后腹腔镜下肾切除术治疗,对照组采用常规根治切除术,记录两组手术情况与调查随访预后情况。结果所有患者都顺利完成手术,对照组的手术时间、术中出血量显著多于观察组(P<0.05),两组术后术后肠道恢复时间、引流管放置时间、住院时间对比差异无统计学意义(P>0.05)。观察组与对照组术后14 d并发症主要为切口感染、肾血管出血、膈肌损伤、皮下气肿、皮下积液,总发生率分别为10.0%和18.4%,均行保守治疗后好转,对比差异无统计学意义(P>0.05)。观察组与对照组术后14 d的血SCr都显著高于术后1 d(P<0.05),观察组术后14 d的血SCr高于对照组(P<0.05)。所有患者随访至今,观察组的中位生存时间为(25.32±3.14)个月,对照组为(24.59±3.98)个月,两组对比差异无统计学意义。结论后腹腔镜下肾切除术治疗肾肿瘤具有很好的可行性与安全性,提高患者的生存期间,减少对患者的创伤,促进患者术后肾功能恢复更快。
Objective To compare the effects of retroperitoneal laparoscopic nephrectomy in the treatment of renal tumors.Methods Used a retrospective summary and research methods,78 cases of renal tumor patients were selected and were divided into 40 cases in the observation group and 38 patients in the control group according to the different surgery ways.The observation group were given laparoscopic nephrectomy,and the control group were given the traditional ways.Recorded the 2 groups of situation and prognosis.Results All patients completed the operation successfully,and the operative time and blood loss in the peripheral group were significantly higher than those of the central group(P<0.05).There were no significant difference in postoperative intestinal recovery time,drainage tube placement time and hospital stay compared between the 2 groups(P>0.05).The postoperative 14 d complications of central group and peripheral group were mainly incisional infection,renal vascular bleeding,diaphragmatic injury,subcutaneous emphysema and subcutaneous effusion,the total incidences rate were10%and 18.4%respectively,all were improved after conservative treatment,there were no significant difference compared between the 2 groups(P>0.05).The postoperative 14 d of blood SCr in the central group and the peripheral group were significantly higher than that of the postoperative 1d(P<0.05),and the central group were higher than that of the peripheral group(P<0.05).All patients were followed up until now,the median survival time of the central group were 25.32±3.14 months,and the peripheral group was 24.59±3.98 months,there were no significant difference compared between the 2 groups(t=0.453,P=0.387).Conclusion The retroperitoneal laparoscopic nephrectomy has good feasibility and safety in the treatment of renal tumors,it can improve the survival time of patients,and it has more less trauma to the central renal tumors and faster recovery of renal function after operation.
作者
周昌东
田玉新
杨新平
王英迪
孙凯
林洋
张奇夫
ZHOU Changdong;TIAN Yuxin;YANG Xinping(Jilin Cancer Hospital,Changchun,130012)
出处
《实用癌症杂志》
2019年第8期1297-1300,1308,共5页
The Practical Journal of Cancer
基金
吉林省直卫生专项项目(编号:sczsy201721)
关键词
后腹腔镜下肾切除术
肾肿瘤
肾功能
并发症
Retroperitoneal nephrectomy
Renal tumor
Renal function
Complication
