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目的比较后腹腔镜根治性肾切除术与开放手术治疗局限性肾癌的临床效果。方法回顾性分析我院2006年1月～2009年1月行后腹腔镜根治性肾切除术(后腹腔镜组)42例与开放根治性肾切除术(开放手术组)45例的临床资料,比较两种手术方法在手术时间、术中出血量、术后肠道恢复时间、术后住院时间、并发症等方面的差异。结果两组手术均获成功。后腹腔镜组的术中出血量、术后肠道恢复时间、术后住院时间等均明显少于开放手术组(P<0.05),而手术时间两组差异无统计学意义。两组均无严重并发症发生,开放手术组2例输血。术后随访3～26个月,平均9个月,后腹腔镜组1例发生肝转移死亡,开放手术组2例出现远处转移而死亡。结论与开放手术相比,后腹腔镜根治性肾切除术具有创伤小、术后恢复快、并发症少等优点,是治疗T1～2N0M0局限性肾癌患者的一种安全、有效的方法。
Objective To compare the clinical effect of retroperitoneal laparoscopic radical nephrectomy and open surgery in the treatment of localized renal cell carcinoma. Methods The clinical data of 42 patients who underwent laparoscopic radical nephrectomy (retroperitoneal laparoscopic group) and 45 patients who underwent open radical nephrectomy (open surgery group) from January 2006 to January 2009 in our hospital were retrospectively analyzed. The differences of operation time, intraoperative blood loss, postoperative intestinal recovery time, postoperative hospital stay and complications were compared between the two methods. Results Both procedures were successful. The postoperative laparoscopic group of intraoperative bleeding, postoperative intestinal recovery time, postoperative hospital stay were significantly less than the open surgery group (P <0.05), while the operation time was no significant difference between the two groups. No serious complications occurred in both groups, and two patients in the open surgery group transfused blood. The patients were followed up for 3 to 26 months with an average of 9 months. One patient in the laparoscopic group died of liver metastasis and 2 patients in the open operation group died of distant metastasis. Conclusions Compared with open surgery, retroperitoneal radical nephrectomy is a safe and effective method for the treatment of T1 ~ 2N0M0 localized renal cell carcinoma with the advantages of less trauma, faster recovery and less complications.