摘要
目的对比3D和2D后腹腔镜下无功能肾切除术的临床疗效,总结后腹腔镜无功能肾切除的手术经验。方法回顾性分析了2015年2月至2018年2月期间我科收治的69例无功能肾患者的临床资料,A组29例使用3D腹腔镜系统,B组40例使用2D腹腔镜系统。对比两组手术时间、术中出血量、术后通气时间、拔除引流管时间、住院时间、中转开放以及手术并发症情况。结果69例手术均由同一术者完成,61例(88.4%)在后腹腔镜下顺利完成手术,8例因粘连严重或大出血而中转开放手术。A组手术时间显著短于B组[(118±21)minvs(134±19)min,t=-3.3003,P=0.0008]。两组术中出血量、术后通气时间、拔除引流管时间、住院时间、手术并发症差异均无统计学意义(P>0.05)。结论后腹腔镜无功能肾切除术是一种安全、有效的肾切除术式。相对2D腹腔镜系统,3D腹腔镜系统有助于提高操作的效率和精准性,熟练后可有效缩短手术时间,值得临床推广应用。
Objective To compare the clinical effect of 3D and 2D retroperitoneal laparoscopic nephrectomy,and summarize the surgical experience of retroperitoneal laparoscopic nephrectomy.Methods The clinical data of 69 cases with nonfunctioning kidney who were treated in our department from February 2015 to February 2018 were analyzed retrospectively.29 cases in group A used laparoscopic 3D system,and 40 cases in group B used 2D laparoscopic system.The operative time,intraoperative blood loss,postoperative intestinal exhaust time,postoperative drainage time,hospital time,transit open surgery and complications were compared between the two groups.Results 69 cases were performed by the same surgeon.61 cases(88.4%)were treated by retroperitoneal laparoscopic nephrectomy successfully.8 cases were transferred to open surgery due to severe adhesion(or massive bleeding).The operation time in group A was significantly shorter than that in group B[(118±21)min vs(134±19)min,t=-3.3003,P=0.0008].There was no significant difference in intraoperative blood loss,postoperative intestinal exhaust time,postoperative drainage time,hospital time and operative complications between the two groups(P>0.05).Conclusion Retroperitoneal laparoscopic nephrectomy is a safe and effective nephrectomy method.Compared with 2D laparoscopic system,3D laparoscopic systems can effectively shorten the operation time after being skilled,it is worthy of clinical application.
作者
毕晓方
平秦榕
王春晖
熊杰
龚瑞
王英宝
李健
钟一鸣
李珲
Bi Xiaofang;Ping Qinrong;Wang Chunhui;Xiong Jie;Gong Rui;Wang Yingbao;Li Jian;Zhong Yiming;Li Hui.(Department of Urology,Yan'an Hospital Affiliated to Kunming Medical University,Kunming,650051,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2019年第5期317-320,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
云南省科技惠民专项(2017RA017)
云南省医疗卫生单位内设机构科研项目(2016NS316)
云南省肿瘤免疫防治重点实验室开放课题(2017DG004-04)
