CAJ | 학술논문

目的：探讨T1期肾癌腹腔镜下行两种不同术式的临床效果。方法回顾分析57例T1期肾癌患者，其中行腹腔镜保留肾单位手术（laparoscopic partial nephrectomy，LPN）36例，腹腔镜肾癌根治性术（laparoscopic radical nephrectomy,）21例，对两组患者在出血量、手术时间、术后平均住院天数以及术后并发症等方面进行统计学比较分析。结果腹腔镜保留肾单位手术组在术后平均住院天数及术后漏尿发生率等方面高于腹腔镜肾癌根治术组，两者差异具有统计学意义（P<0.05）。而在手术时间、术中出血量、术后肾功能衰竭、围手术期死亡、术后泌尿系感染发生率及术中胸膜、肝、脾等脏器损伤的发生率等均低于腹腔镜肾癌根治术组，差异有统计学意义（P<0.05）。结论腹腔镜下保留肾单位手术与肾癌根治术在治疗T1期肾癌中各有优缺点，都是目前较好的治疗T1期肾癌的手术方式，值得临床上推广应用。
목적：탐토T1기신암복강경하행량충불동술식적림상효과。방법회고분석57례T1기신암환자，기중행복강경보류신단위수술（laparoscopic partial nephrectomy，LPN）36례，복강경신암근치성술（laparoscopic radical nephrectomy,）21례，대량조환자재출혈량、수술시간、술후평균주원천수이급술후병발증등방면진행통계학비교분석。결과복강경보류신단위수술조재술후평균주원천수급술후루뇨발생솔등방면고우복강경신암근치술조，량자차이구유통계학의의（P<0.05）。이재수술시간、술중출혈량、술후신공능쇠갈、위수술기사망、술후비뇨계감염발생솔급술중흉막、간、비등장기손상적발생솔등균저우복강경신암근치술조，차이유통계학의의（P<0.05）。결론복강경하보류신단위수술여신암근치술재치료T1기신암중각유우결점，도시목전교호적치료T1기신암적수술방식，치득림상상추엄응용。
Objective To approach clinical curative effect of curing clinical T1 renal carcinoma by the laparoscopic partial nephrectomy and radical nephrectomy. Methods The data of 57 patients with clinical T1 renal carcinoma were reviewed,36 cases with laparoscopic partial nephrectomy and 21cases with laparoscopic radical nephrectomy during a 8-year frame. Parameters associated with the surgical procedures (amount of bleeding during operation, operation time), the hospital stay postoperative and the rate of early complications (less than 3 months after surgery) were compared between the two groups. Results There were significant difference in hospital stay postoperative, volume of blood loss during operation, urinary fistula, renal failure after surgery, mortality after operation and postoperative urinary infection between the two groups(P<0.05). Conclusions the laparoscopic partial nephrectomy and radical nephrectomy are both good forms of clinical T1 renal carcinoma. We failed to find enough evidence that peritoneal laparoscopic partial nephrectomy is better than radical nephrectomy.