中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2013年
2期
105-108
,共4页
王科%门昌平%林春华%谢茂%万逢春%柳东夫%杨典东%高振利
王科%門昌平%林春華%謝茂%萬逢春%柳東伕%楊典東%高振利
왕과%문창평%림춘화%사무%만봉춘%류동부%양전동%고진리
腹腔镜%腹膜后间隙%尿路上皮癌%腹股沟切口%并发症
腹腔鏡%腹膜後間隙%尿路上皮癌%腹股溝切口%併髮癥
복강경%복막후간극%뇨로상피암%복고구절구%병발증
Laparoscopes%Retroperitoneal space%Urinary urothelial carcinoma%Inguinal incision%Complications
目的 探讨腹股沟切口在后腹腔镜上尿路尿路上皮癌根治术中的应用价值. 方法 回顾性分析2007年3月至2012年1月186例采用后腹腔镜下肾输尿管及膀胱袖状切除术治疗上尿路尿路上皮癌患者的资料.男115例,女71例.根据标本取出切口不同分为腹股沟切口组(n=112)和腰部切口组(n =74),比较两组手术时间、术中出血量、术后镇痛治疗、患者住院时间、切口并发症、切口及周围外观满意度及肿瘤复发率的差异. 结果 186例手术均成功,未出现死亡和重大并发症.两组手术时间、术中出血量、肿瘤分期和肿瘤分级方面比较差异均无统计学意义(P＞0.05).腹股沟切口组切口脂肪液化、切口疝、切口膨出、腰腹部不对称发生率以及镇痛治疗率均低于腰部切口组,住院时间短于腰部切口组,切口及周围外观满意度(Ⅰ/Ⅱ/Ⅲ)优于腰部切口组(7/24/81和22/18/34,P＜0.01),输尿管中下段患者肿瘤复发率(5.3％)低于腰部切口组(35.0％,P＜0.01). 结论 联合腹股沟切口的后腹腔镜上尿路尿路上皮癌根治术具有创伤小、切口并发症少、切口及周围外观满意度高、肿瘤复发率低等优点,值得临床推广.
目的 探討腹股溝切口在後腹腔鏡上尿路尿路上皮癌根治術中的應用價值. 方法 迴顧性分析2007年3月至2012年1月186例採用後腹腔鏡下腎輸尿管及膀胱袖狀切除術治療上尿路尿路上皮癌患者的資料.男115例,女71例.根據標本取齣切口不同分為腹股溝切口組(n=112)和腰部切口組(n =74),比較兩組手術時間、術中齣血量、術後鎮痛治療、患者住院時間、切口併髮癥、切口及週圍外觀滿意度及腫瘤複髮率的差異. 結果 186例手術均成功,未齣現死亡和重大併髮癥.兩組手術時間、術中齣血量、腫瘤分期和腫瘤分級方麵比較差異均無統計學意義(P＞0.05).腹股溝切口組切口脂肪液化、切口疝、切口膨齣、腰腹部不對稱髮生率以及鎮痛治療率均低于腰部切口組,住院時間短于腰部切口組,切口及週圍外觀滿意度(Ⅰ/Ⅱ/Ⅲ)優于腰部切口組(7/24/81和22/18/34,P＜0.01),輸尿管中下段患者腫瘤複髮率(5.3％)低于腰部切口組(35.0％,P＜0.01). 結論 聯閤腹股溝切口的後腹腔鏡上尿路尿路上皮癌根治術具有創傷小、切口併髮癥少、切口及週圍外觀滿意度高、腫瘤複髮率低等優點,值得臨床推廣.
목적 탐토복고구절구재후복강경상뇨로뇨로상피암근치술중적응용개치. 방법 회고성분석2007년3월지2012년1월186례채용후복강경하신수뇨관급방광수상절제술치료상뇨로뇨로상피암환자적자료.남115례,녀71례.근거표본취출절구불동분위복고구절구조(n=112)화요부절구조(n =74),비교량조수술시간、술중출혈량、술후진통치료、환자주원시간、절구병발증、절구급주위외관만의도급종류복발솔적차이. 결과 186례수술균성공,미출현사망화중대병발증.량조수술시간、술중출혈량、종류분기화종류분급방면비교차이균무통계학의의(P＞0.05).복고구절구조절구지방액화、절구산、절구팽출、요복부불대칭발생솔이급진통치료솔균저우요부절구조,주원시간단우요부절구조,절구급주위외관만의도(Ⅰ/Ⅱ/Ⅲ)우우요부절구조(7/24/81화22/18/34,P＜0.01),수뇨관중하단환자종류복발솔(5.3％)저우요부절구조(35.0％,P＜0.01). 결론 연합복고구절구적후복강경상뇨로뇨로상피암근치술구유창상소、절구병발증소、절구급주위외관만의도고、종류복발솔저등우점,치득림상추엄.
Objective To evaluate the application of inguinal incision in retroperitoneal laparoscopic nephroureterectomy(LNU)in the treatment of upper urinary urothelial carcinoma(UUUC).Methods From Mar.2007 to Jan.2012,186 retroperitoneal LNU procedures on 115 males and 71 females for the treatment of UUUC were performed in our institute.All cases were grouped as inguinal incision group(n =112)and lumbar incision group(n =74)according to specimen retrieval incision.Operative time,estimated blood loss,postoperative analgesia,hospital stay,incision complications,cosmetic satisfaction and tumor recurrence were compared between the 2 groups.Results All the 186 cases of operation were successfully accomplished.There were no differences in tumor stage,tumor grade,mean operative time,blood loss between the 2 groups.In inguinal incision group,the incidence of incision fat liquefaction,incision hernia,incision bulging,lumboabdominal unsymmetry and postoperative analgesia was less than that of lumbar incision group.In inguinal incision group,the mean hospital stay was shorter,cosmetic satisfaction(Ⅰ/Ⅱ/Ⅲ)was better(7/24/81 versus 22/18/34,P ＜ 0.01).Recurrence rate of UUUC in middle and inferior segment of ureter was fewer than that of lumbar incision group(5.3％ versus 35.0％,P ＜0.01).Conclusion Retroperitoneal LNU for UUUC combined with inguinal incision offers advantage of less trauma,less complications,higher cosmetic satisfaction and lower tumor recurrence.
