国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
International Journal of Urology and Nephrology
2015年
6期
807-810
,共4页
肾肿瘤%外科手术,微创性
腎腫瘤%外科手術,微創性
신종류%외과수술,미창성
Kidney Neoplasms%Surgical Procedures,Minimally Invasive
目的 探讨经腹腔和经腹膜后入路下腹腔镜治疗大体积肾脏恶性肿瘤的效果.方法 本院收治的行根治性手术切除术肾癌患者62例,根据手术入路的不同,分为观察组(40例,经腹膜后入路)和对照组(22例,经腹腔入路).统计并记录两组手术时间、术中出血量、术中及术后并发症、是否输血及是否需入重症监护室(Intensive Care Unit,ICU)、术后住院时间、术后病理结果等.结果 观察组手术时间显著低于对照组(P＜0.05),两组在术中出血量、输血例数、中转开放例数、术中并发症、术后并发症、术后住院日和入ICU例数比较无显著性差异(P＞0.05).观察组包括透明细胞癌33例,乳头状肾细胞癌5例,嫌色细胞癌2例;对照组包括透明细胞癌19例,乳头状肾细胞癌3例.两组均未发现阳性手术切缘.T分期在对照组中更高,差异具有统计学意义(P＞0.05).两组病灶转移率、平均生存期和进展生存期差异无统计学意义(P＞0.05).结论 对于经验丰富的医师,腹腔镜手术治疗大体积肾癌(＞7 cm)是安全可行的,经腹腹腔镜和经后腹膜腹腔镜方式各有其优势,手术方式的选择应该建立在仔细评估病例具体情况的基础上.
目的 探討經腹腔和經腹膜後入路下腹腔鏡治療大體積腎髒噁性腫瘤的效果.方法 本院收治的行根治性手術切除術腎癌患者62例,根據手術入路的不同,分為觀察組(40例,經腹膜後入路)和對照組(22例,經腹腔入路).統計併記錄兩組手術時間、術中齣血量、術中及術後併髮癥、是否輸血及是否需入重癥鑑護室(Intensive Care Unit,ICU)、術後住院時間、術後病理結果等.結果 觀察組手術時間顯著低于對照組(P＜0.05),兩組在術中齣血量、輸血例數、中轉開放例數、術中併髮癥、術後併髮癥、術後住院日和入ICU例數比較無顯著性差異(P＞0.05).觀察組包括透明細胞癌33例,乳頭狀腎細胞癌5例,嫌色細胞癌2例;對照組包括透明細胞癌19例,乳頭狀腎細胞癌3例.兩組均未髮現暘性手術切緣.T分期在對照組中更高,差異具有統計學意義(P＞0.05).兩組病竈轉移率、平均生存期和進展生存期差異無統計學意義(P＞0.05).結論 對于經驗豐富的醫師,腹腔鏡手術治療大體積腎癌(＞7 cm)是安全可行的,經腹腹腔鏡和經後腹膜腹腔鏡方式各有其優勢,手術方式的選擇應該建立在仔細評估病例具體情況的基礎上.
목적 탐토경복강화경복막후입로하복강경치료대체적신장악성종류적효과.방법 본원수치적행근치성수술절제술신암환자62례,근거수술입로적불동,분위관찰조(40례,경복막후입로)화대조조(22례,경복강입로).통계병기록량조수술시간、술중출혈량、술중급술후병발증、시부수혈급시부수입중증감호실(Intensive Care Unit,ICU)、술후주원시간、술후병리결과등.결과 관찰조수술시간현저저우대조조(P＜0.05),량조재술중출혈량、수혈례수、중전개방례수、술중병발증、술후병발증、술후주원일화입ICU례수비교무현저성차이(P＞0.05).관찰조포괄투명세포암33례,유두상신세포암5례,혐색세포암2례;대조조포괄투명세포암19례,유두상신세포암3례.량조균미발현양성수술절연.T분기재대조조중경고,차이구유통계학의의(P＞0.05).량조병조전이솔、평균생존기화진전생존기차이무통계학의의(P＞0.05).결론 대우경험봉부적의사,복강경수술치료대체적신암(＞7 cm)시안전가행적,경복복강경화경후복막복강경방식각유기우세,수술방식적선택응해건립재자세평고병례구체정황적기출상.
Objectives To investigate the clinical outcomes of transperitoneal and retroperitoneal approach in laparoscopic nephrectomy for large renal tumors.Methods 62 cases undergoing eradication operation in our hospital were divided into observation group (40 cases,retroperitoneal approach) and control group (22 cases,transperitoneal approach).The operation duration,bleeding volume,complication occurrence rate,ICU,being hospital time and hostaligical results were determined.Results The operation time of observation group was significantly lower than that of control group (P ＜ 0.05),while no significant difference was found in bleeding volume,complication occurrence rate,ICU,being hospital time (P ＞0.05).There were 33 cases of clear-cell tumor,5 cases of papillary rental cell carcinoma and 2 cases of chromophobe rental cell carcinoma in observation group;19 cases of clcar cell tumor and 3 cases of papillary rental cell carcinoma in control group.No positive surgical margins were found.Control group showed higher T stage,with significant difference (P ＜ 0.05).There was no significant difference between occurrence rate,and average lifetime (P ＞ 0.05).Conclusions Laparoscopic nephrectomy was feasible to treat large renal tumors (＞ 7 cm) for doctors with rich experience.Transperitoneal and retroperitoneal approach in laparoscopic nephrectomy showed different features and the approach choice should made on the basis of precise evaluation on specific situation.
