摘要
目的对比分析开放与后腹腔镜肾部分切除术治疗早期肾癌的安全性与疗效。方法总结2004年12月至2010年2月我中心60例肾癌肾部分切除术,其中开放手术19例,男∶女=17∶2;后腹腔镜手术41例,男∶女=33∶8。对比两组患者基本资料及围手术期相关数据,所有患者肾癌临床分期均为T1N0M0,术后病理证实透明细胞癌54例,乳头状肾细胞癌6例。结果所有手术均获成功,开放组与后腹腔镜组患者年龄分别为(57.7±17.7)岁vs(55.2±16.6)岁(P=0.607);肿瘤直径为(3.3±0.9)cmvs(2.9±1.0)cm(P=0.063);术前肌酐为(107.9±54.7)μmol/Lvs(96.8±18.2)μmol/L(P=0.396);术后肌酐为(117.8±55.9)μmol/Lvs(107.5±19.6)μmol/L(P=0.443);手术前后肌酐变化分别为(9.8±22.2)μmol/L和(9.8±14.3)μmol/L(P=0.988);两组手术时间为(167.9±46.9)minvs(148.5±41.2)min(P=0.108);肾动脉阻断时间为(21.6±10.2)minvs(26.9±9.0)min(P=0.058);术中失血量为(327.9±174.2)mlvs(181.8±120.1)ml(P=0.247);术后住院时间为(11.0±3.4)dvs(8.9±4.0)d(P=0.015)。开放组与后腹腔镜组术后输血患者分别为3例和4例(P=0.668),出现术后并发症的患者分别为2例和3例(P=0.648)。两组患者分别随访38.8及45.4个月,肿瘤控制良好,两组患者末次随访肾功能差异无统计学意义。结论后腹腔镜肾部分切除术在治疗早期肾肿瘤方面,安全性及疗效与开放手术相似,而手术创伤小、恢复速度快。
Objective To compare the safety and efficacy between open partial nephrectomy and retroperitoneal laparoscopic partial nephrectomy in the treatment of early stage renal cell carcinoma. Methods From December 2004 to February 2010, 60 patients who suffered from renal carcinoma underwent partial nephrectomy. Of which, 19 cases were open operation （M/F=17∶2）, and 41 were performed with laparoscope （M/F=33∶8）. We collected and compared the characteristic and perioperative data. All renal carcinoma were confirmed as T1N0M0 by CT scan. The pathologic results： 54 are clear cell carcinoma of kidney, and 6 are papillary renal cell carcinoma. Results All operations were consecutively performed successfully. Data in open partial nephrectomy （OPN） vs data in retroperitoneal laparoscopic partial nephrectomy （RLPN）： Patients′ age were （57.7±17.7） years and （55.2±16.6） years （P=0.607）. Tumor diameter were （3.3±0.9） cm and （2.9±1.0） cm （P=0.063）. The preoperative, postoperative 3 days serum creatinine, and change of serum creatinine were （107.9±54.7） μmol/L and （96.8±18.2） μmol/L （P=0.396）, （117.8±55.9） μmol/L and （107.5±19.6） μmol/L （P=0.443）, and （9.8±22.2） μmol/L and （9.8±14.3） μmol/L （P=0.988）, respectively. Operative duration were （167.9±46.9） min and （148.5±41.2） min（P=0.108）. The duration of renal artery occlusion were （21.6±10.2） min and （26.9±9.0） min（P=0.058）. Intraoperative blood loss were （327.9±174.2） ml and （181.8± 120.1） ml（P=0.247）. Postoperative hospital stay were （11.0±3.4） days and （8.9±4.0） days（P=0.015）.There were 3 patientsin open group and 4 patients in laparoscopic group underwent blood transfusion （P=0.668）. Two cases in open group and 3 patients in laparoscopic group suffered from complications（P=0.648）. The oncologic outcomes and renal function were similar between the two groups at the follow up of 38.8 and 45.4 months. Conclusions RLPN has similar safety and efficacy in the treatment of early stage renal carcinoma with OPN. Moreover, RLPN has less injury and shorter recover duration comparing with OPN.
出处
《现代泌尿生殖肿瘤杂志》
2012年第4期197-199,203,共4页
Journal of Contemporary Urologic and Reproductive Oncology
关键词
肾癌
肾部分切除术
后腹腔镜
Kidney neoplasms
Partial nephrectomy
Retroperitoneal laparoscope
