CAJ | 학술논문

目的：对比研究经腹入路和腹膜后入路腹腔镜下保留肾单位手术治疗T1期肾肿瘤的安全性和可行性，评价手术疗效。方法：回顾性分析郑州大学附属洛阳市中心医院在2012年6月-2015年1月期间收治的52例T1期肾肿瘤患者的临床资料，其中经腹入路28例，经腹膜后入路24例，比较两种手术方法的手术时间、术中失血量、热缺血时间、恢复进食时间、住院时间、切缘阳性率等。结果：所有手术均顺利完成，无明显术中并发症，经腹腔组手术时间为（90.6±25.2）min,腹膜后组为（122.3±30.2）min，两组比较差异有统计学意义（P<0.05）。经腹腔组恢复进食时间（39±9）h和住院时间（8.8±1.7）d较腹膜后组（26±6）h、（6.3±1.4）d的时间较长，两组比较差异有统计学意义（P<0.05）。两组术中热缺血时间、失血量、切缘阳性率比较差异无统计学意义（P>0.05）。结论：两种手术入路腹腔镜下保留肾单位手术均是治疗T1期的安全有效的方法。经腹入路操作空间大，易于手术操作；经腹膜后入路术后恢复较快。
목적：대비연구경복입로화복막후입로복강경하보류신단위수술치료T1기신종류적안전성화가행성，평개수술료효。방법：회고성분석정주대학부속락양시중심의원재2012년6월-2015년1월기간수치적52례T1기신종류환자적림상자료，기중경복입로28례，경복막후입로24례，비교량충수술방법적수술시간、술중실혈량、열결혈시간、회복진식시간、주원시간、절연양성솔등。결과：소유수술균순리완성，무명현술중병발증，경복강조수술시간위（90.6±25.2）min,복막후조위（122.3±30.2）min，량조비교차이유통계학의의（P<0.05）。경복강조회복진식시간（39±9）h화주원시간（8.8±1.7）d교복막후조（26±6）h、（6.3±1.4）d적시간교장，량조비교차이유통계학의의（P<0.05）。량조술중열결혈시간、실혈량、절연양성솔비교차이무통계학의의（P>0.05）。결론：량충수술입로복강경하보류신단위수술균시치료T1기적안전유효적방법。경복입로조작공간대，역우수술조작；경복막후입로술후회복교쾌。
Objective:To compare the safety and feasibility of transperitoneal and retroperitoneal laparoscopic partial nephrectomy (LPN) in the treatment of renal neoplasm with T1 stage.Method:The medical records of 52 patients with renal neoplasm in T1 stage underwent transperitoneal LPN of 28 cases and retroperitoneal LPN of 24 cases were retrospectively reviewed from June 2010 to January 2015.The mean operative time,estimated blood loss, warm ischemia time, tolerating regular diet time, postoperative hospital stay and surgical margin were compared between the two groups. Result:All the patients’ operation were successfully completed without complications intraoperative.The transperitoneal LPN group had a shorter mean operative time (90.6±25.2)min than retroperitoneal LPN group (122.3±30.2) min, the difference was statistically significant(P<0.05).But showed longer tolerating regular diet time (39±9)h than (26±6)h and postoperative hospital stay time (8.8±1.7)d than (6.3±1.4)d,the difference was statistically significant(P<0.05).No significant differences in warm ischemia time,estimated blood loss,and surgical margin between the two groups(P<0.05).Conclusion:Both transperitoneal LPN and retroperitoneal LPN are safe and effective for surgical management of renal tumors with T1 stage,the transperitoneal procedure offers larger operative space with better exposure,the retroperitoneal procedure better promotes postoperative recovery of the patients.