后腹腔镜肾部分切除术治疗肾肿瘤的疗效及安全性分析

Efficacy and safety of retroperitoneal laparoscopic partial nephrectomy in treatment of renal tumors

摘要:

目的探讨后腹腔镜肾部分切除术治疗肾肿瘤的临床疗效及安全性。方法选取2010 年1 月-2015 年7 月该院42 例肾肿瘤患者，根据随机数字法，将其分为开放手术组（开放肾部分切除术）和腹腔镜手术组（后腹腔镜肾部分切除术），每组各21 例，比较两组手术时间、Scr 水平、术后胃肠功能恢复时间、住院时间、根据视觉模拟疼痛评分（VAS）及术后并发症。结果腹腔镜手术组手术时间及手术前后Scr 水平与开放手术组比较，差异无统计学意义（p >0.05）；与开放手术组比较，腹腔镜手术组术后胃肠功能恢复时间、住院时间均缩 短，术中出血量更少，术后1 周VAS 降低；与开放手术组比较，腹腔镜手术组术后并发症发生率降低。结论对于肾肿瘤患者，后腹腔镜肾部分切除术作为一种安全、有效的手术方式，值得临床推广。

Abstract:

Objective To study the clinical efficacy and safety of retroperitoneal laparoscopic partial nephrectomy for renal tumors. Methods The 42 patients with renal tumors in our hospital during the period from January 2010 to July 2015 were randomized into open surgery group (open partial nephrectomy) and laparoscopic surgery group (retroperitoneal laparoscopic partial nephrectomy) according to the random number method with 21 patients per group. The operation time, Scr, postoperative recovery time of gastrointestinal function, hospitalization time, VAS score, and postoperative complications were compared between the two groups. Results There was no statistical difference in the operation time or preoperative or postoperative Scr level between the two groups (p > 0.05). Compared with the open surgery group, the postoperative recovery time of gastrointestinal function and hospitalization time were shortened, the intraoperative blood loss was less,the postoperative VAS score decreased and the incidences of postoperative complications were reduced in the laparoscopic surgery group (p < 0.05). Conclusions For the renal tumor patients, the retroperitoneal laparoscopic partial nephrectomy is a safe and effective surgical method, and is worthy of clinical promotion.