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目的:对比分析开放根治性和后腹腔镜肾切除术的手术效果。方法:回顾对比分析2009年10月-2012年4月行开放根治性肾切除术28例和后腹腔镜肾切除术25例,观察手术时间、术中出血量,术后胃肠恢复时间,术后住院时间等情况。结果:开放根治性肾切除术手术时间为65-250 min平均155 min。后腹腔镜肾切除术手术时间70-240 min,平均152 min。两者不具有统计学差异(P>0.05)。开放根治性肾切除术手术术中出血200~1000mL,平均600 mL。后腹腔镜肾切除术手术术中出血50-320 mL,平均165 mL。两者具有统计学差异(P<0.05)。开放根治性肾切除术手术术后胃肠功能恢复时间48-98 h,平均74 h;术后住院时间7-12 d,平均10 d。后腹腔镜肾切除术手术术后胃肠功能恢复时间18-72 h,平均35 h;术后住院时间4-8 d,平均7 d。两者具有统计学差异(P<0.05)。结论:后腹腔镜下手术肾切除具有创伤小、出血少、恢复快等优点,但对适应症选择方面应慎重。
Objective: To compare and analyze the effect of open radical and retroperitoneoscopic nephrectomy. Methods: A retrospective comparative analysis was performed between October 2009 and April 2012 in 28 patients undergoing radical nephrectomy and 25 after laparoscopic nephrectomy. The operative time, intraoperative blood loss, postoperative gastrointestinal recovery time, After hospitalization and so on. Results: The open radical nephrectomy operation time was 65-250 min with an average of 155 min. Laparoscopic nephrectomy operation time 70-240 min, an average of 152 min. There was no statistical difference between the two groups (P> 0.05). Open radical nephrectomy surgery intraoperative bleeding 200 ~ 1000mL, an average of 600mL. Postoperative laparoscopic nephrectomy bleeding 50-320 mL, an average of 165 mL. The difference was statistically significant (P <0.05). Open radical nephrectomy postoperative gastrointestinal function recovery time 48-98 h, an average of 74 h; postoperative hospital stay 7-12 d, an average of 10 d. Postoperative laparoscopic nephrectomy postoperative gastrointestinal function recovery time 18-72 h, an average of 35 h; postoperative hospital stay 4-8 d, an average of 7 d. The difference was statistically significant (P <0.05). Conclusion: Retroperitoneal laparoscopic nephrectomy has the advantages of less trauma, less bleeding and faster recovery, but caution should be used in the selection of indications.