摘要
目的探讨三维(3D)腹腔镜根治术治疗肾癌的疗效及对患者免疫功能的影响。方法选取52例肾癌患者,根据手术方式的不同将患者分为观察组28例(行3D腹腔镜根治术)和对照组24例[行传统的二维(2D)腹腔镜手术]。比较两组患者的围手术期相关指标(手术时间、术后引流管拔除时间、术后住院时间、术后免疫功能恢复时间、术中失血量)、术中输血情况、术后转重症监护室(ICU)率、手术相关并发症发生情况及术后复发或远处转移情况,以及不同时间点的T淋巴细胞亚群水平。结果观察组中有1例患者中转开放性手术并顺利完成手术,其他27例患者的手术均获得成功。对照组患者均顺利完成传统的2D腹腔镜手术。观察组出现肺转移1例,对照组出现肺转移和肝转移各1例;3例患者均带瘤生存,未见局部复发、切口感染和穿刺孔种植。观察组患者的手术时间、术后引流管拔除时间、术后住院时间、术后免疫功能恢复时间均短于对照组患者,术中失血量少于对照组患者(P﹤0.05)。两组患者均未进行术中输血,且术后转ICU率、围手术期并发症发生率、术后复发或远处转移率比较,差异均无统计学意义(P﹥0.05)。两组间的T淋巴细胞亚群水平以及组内不同时间点的T淋巴细胞亚群水平比较,差异均有统计学意义(P﹤0.01);组别与时间存在交互作用(P﹤0.05)。结论3D腹腔镜根治术治疗肾癌是可行的,其在减轻手术创伤、促进术后恢复和保护免疫功能方面均具有优势,近期疗效和安全性均令人满意,值得进一步推广应用。
Objective To analyze the effect of three dimensional(3D)laparoscopic radical surgery on renal carcinoma and its effect on immune function.Method 52 patients with renal carcinoma were selected and divided into observation group(28 cases underwent 3D laparoscopic radical surgery)and control group[24 cases underwent traditional two dimensional(2D)laparoscopic surgery].The related perioperative information(sugery duration,extubation time of drainage tube,postoperative hospitalization duration,postoperative immune function recovery time,and intraoperative blood loss),intraoperative blood transfusion,postoperative intensive care unit(ICU)transfer rate,surgical related complications,postoperative recurrence and distant metastases,and levels of T lymphcyte subgroup at different time points were compared.Result One patient in the observation group was transferred to open surgery and successfully underwent the surgery;the other 27 patients all underwent surgery succssfully and all the patients in the control group underwent traditional 2D laparoscopic surgery successfully.One case with lung metastases in the observation group and one case each with lung metastases and liver metastases in the control group all survived with tumors,No local recurrence,infection of incision,and port site metastases were observed.The sugery duration,extubation time of drainage tube,postoperative hospitalization duration,postoperative immune function recovery time,and intraoperative blood loss were less than those of control group(P<0.05).No blood transfusion was performed in both goups,and there were no significant differences in postoperative ICU transfer rate,perioperative complications,postoperative recurrence and distant metastases in two groups(P>0.05).The levels of T lymphcyte subgroup in two groups and at different time points within the same group were significantly different(P<0.01).There was interaction for grouping and time(P<0.05).Conclusion 3D laparoscopic radical surgery is feasible for the treatment of renal carcinoma with advantages in reducing surgical trauma,promoting postoperative recovery and protecting immune function and satisfactory short-term efficacy and safety,which is worthy of further research and application.
作者
李岗
孙文衍
王旭
孙峰
朱家红
LI Gang;SUN Wenyan;WANG Xu;SUN Feng;ZHU Jiahong(Department of Urology, Bozhou People’s Hospital, Bozhou 236800, Anhui, China;Department of Urology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui, China)
出处
《癌症进展》
2019年第11期1292-1295,1331,共5页
Oncology Progress
关键词
肾癌
腹腔镜根治术
三维
二维
免疫功能
renal carcinoma
laparoscopic radical surgery
3D
2D
immune function
