摘要
目的:探究不同入路腹腔镜保留肾单位肾肿瘤切除术的治疗效果。方法:选取82例行腹腔镜保留肾单位肾肿瘤切除术的肾肿瘤患者为研究对象,根据手术入路不同分为经腹腔入路组和经腹膜后入路组,每组各41例。比较两组患者手术相关恢复指标、术后并发症、不同时间点肌酐(SCr)及尿素氮(BUN)和癌症患者生存质量测定量表(EORTC QOL-C30)评分。结果:经腹膜后入路组小鼠的手术时间、术后通气时间及平均住院时间均短于经腹腔入路组(P<0.05),术中出血量少于经腹腔入路组(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);术后24 h、3个月,两组尿液SCr及BUN水平均先升高后下降(P<0.05),组间比较差异无统计学意义(P>0.05);术后3个月,两组EORTC QOL-C30量表中关于躯体功能、情绪功能、社会功能、认知功能及总体生活质量共5项评分较术前均下降(P<0.05),但组间比较无统计学差异(P>0.05)。结论:相比经腹腔入路,选择经腹膜后入路用于腹腔镜保留肾单位肾肿瘤切除术可缩短手术时间,减少术中出血量,促进肾肿瘤患者术后恢复。
Objective:To explore the therapeutic effects of different approaches of laparoscopic nephron sparing nephrectomy in the treatment of renal tumors.Methods:82 patients with renal tumors who underwent laparoscopic nephron sparing nephrectomy were selected as the study subjects and divided into transperitoneal approach group(n=41)and retroperitoneal approach group(n=41)according to different surgical approaches.The surgery-related recovery indicators,postoperative complications,serum creatinine(SCr)and blood urea nitrogen(BUN)at different time points and European Organization for Research and Treatment of Cancer Quality of Life C30(EORTC QOL-C30)scores were compared between the two groups.Results:The surgical time,postoperative ventilation time and average hospital stay in retroperitoneal approach group were shorter than those in transperitoneal approach group(P<0.05),and the intraoperative blood loss was less than that in transperitoneal approach group(P<0.05).There was no statistical difference in the incidence rate of postoperative complications between the two groups(P>0.05).At 24 hours and 3 months after surgery,the levels of urine Scr and BUN in the two groups were increased first and then decreased(P<0.05),but there were no differences between both groups(P>0.05).At 3 months after surgery,the scores of five items of physical function,emotional function,social function,cognitive function and overall quality of life of EORTC QOL-C30 scale in both groups were decreased compared with those before surgery(P<0.05),but there were no statistical differences between the two groups(P>0.05).Conclusion:Compared with transperitoneal approach,retroperitoneal approach in laparoscopic nephron sparing nephrectomy can better shorten the surgical time,reduce the intraoperative blood loss,and promote the postoperative recovery of patients with renal tumors.
作者
林山
黄令杰
朱显钟
张汉荣
李金雨
LIN Shan;HUANG Ling-jie;ZHU Xian-zhong;ZHANG Han-rong;LI Jin-yu(Department of Urology Surgery,the 909th Hospital of the Joint Logistics Support Force of PLA,Southeast Hospital Affiliated to Xiamen University,Zhangzhou 363000,Fujian,China)
出处
《川北医学院学报》
CAS
2023年第6期818-821,共4页
Journal of North Sichuan Medical College
关键词
经腹腹腔镜入路
腹膜后腹腔镜入路
保留肾单位肾肿瘤切除术
肾肿瘤
Transperitoneal laparoscopic approach
Retroperitoneal laparoscopic approach
Nephron sparing nephrectomy
Renal tumors
