中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2015年
3期
181-184
,共4页
腹腔镜%腹股沟小切口%尿路上皮癌
腹腔鏡%腹股溝小切口%尿路上皮癌
복강경%복고구소절구%뇨로상피암
Laparoscopes%Inguen small incision%Urothelium carcinoma
目的 探讨后腹腔镜联合腹股沟小切口手术治疗尿路上皮癌的临床疗效.方法 将98例尿路上皮癌患者根据手术方式的不同分为两组:观察组56例行后腹腔镜联合腹股沟小切口手术,对照组42例行传统开放手术.记录手术时间、术中出血量、术后引流量、术后胃肠功能恢复时间、术后下床活动时间、引流管拔除时间、住院时间,统计切口脂肪液化、切口疝、切口膨出、切口疼痛不适、术后镇痛治疗、术后3个月切口美容满意及术后36个月内肿瘤复发情况.结果 观察组手术时间、术中出血量、术后胃肠功能恢复时间、术后下床活动时间、住院时间明显少于对照组[(135.23 ±32.18) min比(177.58 ±57.29) min、(119.33 ±35.02) ml比(161.29 ±72.06) ml、(2.03±0.73)d比(2.79±0.79)d、(20.68±9.75)h比(32.41±11.12)h、(8.51±0.93)d 比(9.81±2.21)d],差异有统计学意义(P＜ 0.05或＜0.01);两组术后引流量、引流管拔除时间比较差异无统计学意义(P＞0.05).观察组切口脂肪液化、切口疝、切口膨出、切口疼痛不适及术后镇痛治疗率均明显低于对照组[1.79％(1/56)比26.19％ (11/42)、0比11.90％ (5/42)、0比7.14％(3/42)、1.79％(1/56)比11.90％ (5/42)、1.79％(1/56)比11.90％(5/42)],术后3个月切口美容满意率明显高于对照组[92.86％(52/56)比78.57％(33/42)],差异有统计学意义(P＜ 0.01或＜0.05).观察组肿瘤复发率明显低于对照组[14.29％(8/56)比47.62％(20/42)],差异有统计学意义(P＜0.01).结论 后腹腔镜联合腹股沟小切口手术治疗尿路上皮癌可明显减少患者的治疗和恢复时间,且切口美观,患者满意度提高,同时术后肿瘤复发率低.
目的 探討後腹腔鏡聯閤腹股溝小切口手術治療尿路上皮癌的臨床療效.方法 將98例尿路上皮癌患者根據手術方式的不同分為兩組:觀察組56例行後腹腔鏡聯閤腹股溝小切口手術,對照組42例行傳統開放手術.記錄手術時間、術中齣血量、術後引流量、術後胃腸功能恢複時間、術後下床活動時間、引流管拔除時間、住院時間,統計切口脂肪液化、切口疝、切口膨齣、切口疼痛不適、術後鎮痛治療、術後3箇月切口美容滿意及術後36箇月內腫瘤複髮情況.結果 觀察組手術時間、術中齣血量、術後胃腸功能恢複時間、術後下床活動時間、住院時間明顯少于對照組[(135.23 ±32.18) min比(177.58 ±57.29) min、(119.33 ±35.02) ml比(161.29 ±72.06) ml、(2.03±0.73)d比(2.79±0.79)d、(20.68±9.75)h比(32.41±11.12)h、(8.51±0.93)d 比(9.81±2.21)d],差異有統計學意義(P＜ 0.05或＜0.01);兩組術後引流量、引流管拔除時間比較差異無統計學意義(P＞0.05).觀察組切口脂肪液化、切口疝、切口膨齣、切口疼痛不適及術後鎮痛治療率均明顯低于對照組[1.79％(1/56)比26.19％ (11/42)、0比11.90％ (5/42)、0比7.14％(3/42)、1.79％(1/56)比11.90％ (5/42)、1.79％(1/56)比11.90％(5/42)],術後3箇月切口美容滿意率明顯高于對照組[92.86％(52/56)比78.57％(33/42)],差異有統計學意義(P＜ 0.01或＜0.05).觀察組腫瘤複髮率明顯低于對照組[14.29％(8/56)比47.62％(20/42)],差異有統計學意義(P＜0.01).結論 後腹腔鏡聯閤腹股溝小切口手術治療尿路上皮癌可明顯減少患者的治療和恢複時間,且切口美觀,患者滿意度提高,同時術後腫瘤複髮率低.
목적 탐토후복강경연합복고구소절구수술치료뇨로상피암적림상료효.방법 장98례뇨로상피암환자근거수술방식적불동분위량조:관찰조56례행후복강경연합복고구소절구수술,대조조42례행전통개방수술.기록수술시간、술중출혈량、술후인류량、술후위장공능회복시간、술후하상활동시간、인류관발제시간、주원시간,통계절구지방액화、절구산、절구팽출、절구동통불괄、술후진통치료、술후3개월절구미용만의급술후36개월내종류복발정황.결과 관찰조수술시간、술중출혈량、술후위장공능회복시간、술후하상활동시간、주원시간명현소우대조조[(135.23 ±32.18) min비(177.58 ±57.29) min、(119.33 ±35.02) ml비(161.29 ±72.06) ml、(2.03±0.73)d비(2.79±0.79)d、(20.68±9.75)h비(32.41±11.12)h、(8.51±0.93)d 비(9.81±2.21)d],차이유통계학의의(P＜ 0.05혹＜0.01);량조술후인류량、인류관발제시간비교차이무통계학의의(P＞0.05).관찰조절구지방액화、절구산、절구팽출、절구동통불괄급술후진통치료솔균명현저우대조조[1.79％(1/56)비26.19％ (11/42)、0비11.90％ (5/42)、0비7.14％(3/42)、1.79％(1/56)비11.90％ (5/42)、1.79％(1/56)비11.90％(5/42)],술후3개월절구미용만의솔명현고우대조조[92.86％(52/56)비78.57％(33/42)],차이유통계학의의(P＜ 0.01혹＜0.05).관찰조종류복발솔명현저우대조조[14.29％(8/56)비47.62％(20/42)],차이유통계학의의(P＜0.01).결론 후복강경연합복고구소절구수술치료뇨로상피암가명현감소환자적치료화회복시간,차절구미관,환자만의도제고,동시술후종류복발솔저.
Objective To analyze the clinical curative effect of retroperitoneoscopy combined with inguen small incision surgery in treatment of urothelium carcinoma.Methods Ninety-eight urothelium carcinoma patients were divided into observation group (56 cases) and control group (42 cases) according to the surgery method.The patients in observation group were treated with retroperitoneoscopy combined with inguen small incision surgery,and the patients in control group were treated with open surgery.The operation time,intraoperative bleeding volume,postoperative drainage volume,postoperative gastrointestinal function recovery time,postoperative ambulation time,drainage tube removal time,hospitalization time,incision fat liquefaction,incision hernia,incision prolapse,incision pain and discomfort,postoperative analgesia,postoperative 3 months incision satisfaction and postoperative 36 months tumor recurrence were observed.Results The operation time,intraoperative bleeding volume,postoperative gastrointestinal function recovery time,postoperative ambulation time and hospitalization time in observation group were significantly lower than those in control group:(135.23 ±32.18) min vs.(177.58 ±57.29) min,(119.33 ±35.02) ml vs.(161.29 ± 72.06) ml,(2.03 ± 0.73) d vs.(2.79 ± 0.79) d,(20.68 ± 9.75) h vs.(32.41 ± 11.12) h,(8.51 ± 0.93) d vs.(9.81 ± 2.21) d,and there were statistical differences (P ＜ 0.05 or ＜ 0.01).There were no statistical differences in postoperative drainage volume and drainage tube removal time between 2 groups (P ＞ 0.05).The rates of incision fat liquefaction,incision hernia,incision prolapse,incision pain and discomfort and postoperative analgesia in observation group were significantly lower than those in control group:1.79％ (1/56) vs.26.19％ (11/42),0 vs.11.90％ (5/42),0 vs.7.14％ (3/42),1.79％ (1/56) vs.11.90％ (5/42),1.79％ (1/56)vs.11.90％ (5/42),the rate of postoperative 3 months incision satisfaction in observation group (92.86％,52/56) was significantly higher than that in control group (78.57％,33/42),and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The rate of tumor recurrence in observation group (14.29％,8/56) was significantly lower than that in control group (47.62％,20/42),and there was statistical difference (P ＜ 0.01).Conclusions Retroperitoneoscopy combined with inguen small incision surgery in treatment of urothelium carcinoma can significantly reduce the patients' treatment and recovery time,improve the beauty of incision and patients' satisfaction degree,and reduce the postoperative tumor recurrence rate.
