肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
3期
185-187
,共3页
肾肿瘤%肾盂%腹腔镜检查%肾切除术
腎腫瘤%腎盂%腹腔鏡檢查%腎切除術
신종류%신우%복강경검사%신절제술
Kidney neoplasms%Kidney pelvis%Laparoscopy%Nephrectomy
目的 比较经尿道输尿管口袖口状电切联合后腹腔镜肾切除与后腹双切口开放手术在肾盂癌治疗中的疗效及不良反应.方法 回顾性分析2001年7月至2009年7月42例经尿道输尿管口袖口状电切联合后腹腔镜肾切除(微创手术组)与20例后腹双切口开放手术(开放手术组)进行肾盂癌根治术患者的资料,通过对手术时间、出血量、中转开放情况、术中及术后并发症、住院时间、术后肿瘤复发及转移例数等数据的统计,对两种术式的操作步骤及手术经验进行比较.结果 微创手术组与开放手术组比较,手术时间[(147.34±39.16)和(158.88±42.12)min]、下地活动时间[(3.58±0.79)和(5.67±1.24)d]、住院时间[(9.15±2.19)和(11.64±3.71)d]明显缩短(t值分别为3.3167、2.0587、8.0494,P值均＜0.05),术中出血量[(70.64±27.33)和(118.17±44.65)ml]明显降低(t=5.1777,P＜0.05).但在手术初期,微创手术组有4例患者腹腔镜手术中转开放手术.术后随访8～48个月,微创手术组与开放手术组远处转移率分别为2.4%(1/42)和5.0%(1/20),局部复发率为4.8%(2/42)和5.0%(1/20),术中并发症发生率分别为4.8%(2/42)和5.0%(1/20),术后并发症发生率均为0,2组患者远处转移及局部复发率、术中及术后并发症发生率差异均无统计学意义(P＞0.05).结论 后腹腔镜联合经尿道输尿管口袖状电切治疗肾盂癌与开放手术相比具有创伤小、解剖层次清晰、术中出血少、术后恢复快等特点,治疗效果及术后肿瘤复发等情况与开放手术相似.
目的 比較經尿道輸尿管口袖口狀電切聯閤後腹腔鏡腎切除與後腹雙切口開放手術在腎盂癌治療中的療效及不良反應.方法 迴顧性分析2001年7月至2009年7月42例經尿道輸尿管口袖口狀電切聯閤後腹腔鏡腎切除(微創手術組)與20例後腹雙切口開放手術(開放手術組)進行腎盂癌根治術患者的資料,通過對手術時間、齣血量、中轉開放情況、術中及術後併髮癥、住院時間、術後腫瘤複髮及轉移例數等數據的統計,對兩種術式的操作步驟及手術經驗進行比較.結果 微創手術組與開放手術組比較,手術時間[(147.34±39.16)和(158.88±42.12)min]、下地活動時間[(3.58±0.79)和(5.67±1.24)d]、住院時間[(9.15±2.19)和(11.64±3.71)d]明顯縮短(t值分彆為3.3167、2.0587、8.0494,P值均＜0.05),術中齣血量[(70.64±27.33)和(118.17±44.65)ml]明顯降低(t=5.1777,P＜0.05).但在手術初期,微創手術組有4例患者腹腔鏡手術中轉開放手術.術後隨訪8～48箇月,微創手術組與開放手術組遠處轉移率分彆為2.4%(1/42)和5.0%(1/20),跼部複髮率為4.8%(2/42)和5.0%(1/20),術中併髮癥髮生率分彆為4.8%(2/42)和5.0%(1/20),術後併髮癥髮生率均為0,2組患者遠處轉移及跼部複髮率、術中及術後併髮癥髮生率差異均無統計學意義(P＞0.05).結論 後腹腔鏡聯閤經尿道輸尿管口袖狀電切治療腎盂癌與開放手術相比具有創傷小、解剖層次清晰、術中齣血少、術後恢複快等特點,治療效果及術後腫瘤複髮等情況與開放手術相似.
목적 비교경뇨도수뇨관구수구상전절연합후복강경신절제여후복쌍절구개방수술재신우암치료중적료효급불량반응.방법 회고성분석2001년7월지2009년7월42례경뇨도수뇨관구수구상전절연합후복강경신절제(미창수술조)여20례후복쌍절구개방수술(개방수술조)진행신우암근치술환자적자료,통과대수술시간、출혈량、중전개방정황、술중급술후병발증、주원시간、술후종류복발급전이례수등수거적통계,대량충술식적조작보취급수술경험진행비교.결과 미창수술조여개방수술조비교,수술시간[(147.34±39.16)화(158.88±42.12)min]、하지활동시간[(3.58±0.79)화(5.67±1.24)d]、주원시간[(9.15±2.19)화(11.64±3.71)d]명현축단(t치분별위3.3167、2.0587、8.0494,P치균＜0.05),술중출혈량[(70.64±27.33)화(118.17±44.65)ml]명현강저(t=5.1777,P＜0.05).단재수술초기,미창수술조유4례환자복강경수술중전개방수술.술후수방8～48개월,미창수술조여개방수술조원처전이솔분별위2.4%(1/42)화5.0%(1/20),국부복발솔위4.8%(2/42)화5.0%(1/20),술중병발증발생솔분별위4.8%(2/42)화5.0%(1/20),술후병발증발생솔균위0,2조환자원처전이급국부복발솔、술중급술후병발증발생솔차이균무통계학의의(P＞0.05).결론 후복강경연합경뇨도수뇨관구수상전절치료신우암여개방수술상비구유창상소、해부층차청석、술중출혈소、술후회복쾌등특점,치료효과급술후종류복발등정황여개방수술상사.
Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision and open nephroureterectomy in pelvis carcinoma. Methods We retrospectively analysed the records of all 62 patients who underwent retroperitoneal laparoscopic or open nephroureterectomy in Tianjin Dagang Hospital or the Second Affiliated Hospital of Tianjin Medical University from July 2001 to July 2009. Variables analyse were compared including operative time, blood loss, turning to open operation, complications, length of stay, tumor recurrence and metastasis. Groups were compared using Student's t-test, and a probability (P) value of less than 0.05 was taken to indicate statistical significance. Results The respective mean operative duration [(47.34±39.16) vs (118.17±44.65) ml], length of hospital stay [(9.15±2.19) vs (11.64±3.71) d], time to ambulation [(3.58±0.79) vs (5.67±1.24) d]and blood loss [(70.64±27.33) vs (118.17±44.65) ml]in retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision group was significantly reduce to open nephroureterectomy group (t = 3.3167, 2.0587, 8.0494, 5.1777, P ＜0.05). There was no significantly difference between two groups in complication of during operation and post operation [4.8 % (2/42) vs 5.0 %(1/20), 0 vs 0, respectively](P ＞0.05). 4 cases were failed and conversed to open surgery in retroperitoneal laparoscopic nephroureterectomy group. During the follow up period range from 8-48 months, there was no significantly difference between two groups in tumor recurrence and metastasis [4.8 % (2/42) vs 5.0 % (1/20),2.4 % (1/42) vs 5.0 % (1/20), respectively](P ＞0.05). Conclusion Retroperitoneal laparoscopy in upper urinary tract transitional carcinoma uses a small incision, incurs less blood loss, and allows for a more rapid recovery, suggesting it is a safe and effective method for treating patients with renal and pelvis cancer.
