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目的:评估经腹路径及经后腹腔路径行腹腔镜根治性肾切除术的临床疗效。方法:回顾性分析2008年3月~2014年6月于大连医科大学附属二院行腹腔镜肾根治性切除术的患者73例,依据手术方式不同分为经腹路径组(32例)及后腹腔路径组(41例),比较两组患者在手术时间、术后住院时间、术中出血量及肛门排气时间等临床资料的差异。结果:经腹路径组患者肿瘤大小为(5.62±1.51)cm,大于后腹腔路径组患者的(4.41±1.78)cm,差异有统计学意义(P=0.032);经腹路径组患者的平均手术时间为(169±53.8)min,高于后腹腔路径组的(151±47.9)min,差异有统计学意义(P=0.036)。两组在术中出血量、术后住院时间及手术并发症发生率方面相比,差异无统计学意义(P>0.05)。结论:两种路径腹腔镜根治性肾切除术均获得良好的临床疗效,经腹路径更适用于体积较大的肿瘤。
Objective: To evaluate the clinical efficacy of laparoscopic radical nephrectomy in the transabdominal and transperitoneal routes. Methods: From March 2008 to June 2014, 73 patients undergoing laparoscopic radical nephrectomy in the Second Affiliated Hospital of Dalian Medical University were retrospectively analyzed. According to the different surgical methods, they were divided into two groups (32 cases) (41 cases). The differences of clinical data between two groups were compared in terms of operation time, postoperative hospital stay, intraoperative blood loss and anal exhaust time. Results: The size of the tumor in the transabdominal group was (5.62 ± 1.51) cm, which was significantly higher than that in the group of the posterior abdominal pathological group (4.41 ± 1.78) cm, the difference was statistically significant (P = 0.032) The time was (169 ± 53.8) min and higher than that of the posterior abdominal celiac group (151 ± 47.9) min, the difference was statistically significant (P = 0.036). There was no significant difference between the two groups in terms of intraoperative blood loss, postoperative hospital stay and incidence of surgical complications (P> 0.05). Conclusions: Both approaches have a good clinical effect in laparoscopic radical nephrectomy. Transabdominal approach is more suitable for larger tumors.