论文部分内容阅读
目的比较腹腔镜和开放行根治性肾切除术治疗T2期肾癌的临床效果。方法对同期138例肾癌患者分别行腹腔镜或开放根治性肾切除术,腹腔镜手术组63例,开放手术组75例。比较两组术中出血量、手术时间、术后进食时间及住院时间等指标。结果腹腔镜肾根治性切除术手术时间为90～385 min,平均(213±61.6)min;开放手术时间为55～320min,平均(173±52.3)min,二者差异有统计学意义(P=0.000)。腹腔镜手术组术中失血量为30～1 600 ml,平均(220±291.8)ml;开放手术组术中失血量为50～1 400 ml,平均(319±244.1)ml,差异有统计学意义(P=0.032)。经腹腹腔镜组术后1～4 d进食,平均(2.4±0.82)d;经后腹膜腹腔镜组为术后2～5 d进食,平均(3.1±1.02)d,差异有统计学意义(P=0.000)。经腹腹腔镜组术后住院4～15 d,平均(7.3±2.50)d;经后腹膜腹腔镜组术后住院6～15 d,平均(9.3±2.25)d,差异有统计学意义(P=0.000)。结论腹腔镜根治性肾切除术有出血少、术后进食早和术后住院时间短等优点,术后并发症发生率与开放手术相近,腹腔镜根治性肾切除术治疗T2期肾癌安全可行。
Objective To compare the clinical efficacy of laparoscopic and open radical nephrectomy in the treatment of T2 stage renal cell carcinoma. Methods Laparoscopic or open radical nephrectomy was performed on 138 patients with renal cell carcinoma in the same period, including 63 cases of laparoscopic surgery and 75 cases of open surgery. The blood loss, operation time, postoperative eating time and hospital stay were compared between the two groups. Results The operation time of laparoscopic radical nephrectomy was 90-385 min (mean, 213 ± 61.6) min, and the open operation time was 55-320 min (mean, 173 ± 52.3 min). The difference was statistically significant (P = 0.000). The intraoperative blood loss in laparoscopic surgery group was 30-1 600 ml (mean, 220 ± 291.8) ml. In the open surgery group, the intraoperative blood loss was 50-1 400 ml (mean, 319 ± 244.1) ml, with significant difference (P = 0.032). The patients in the laparoscopic group had an average of (2.4 ± 0.82) days after the operation, and the average time was (3.1 ± 1.02) days after the laparoscopic operation. The difference was statistically significant ( P = 0.000). The patients in the laparoscopic group had an average of (7.3 ± 2.50) d after hospitalization for 4 to 15 days, and were hospitalized for 6 to 15 days after the laparoscopic laparoscopic operation (average, 9.3 ± 2.25) days, with significant difference (P = 0.000). Conclusions Laparoscopic radical nephrectomy has the advantages of less bleeding, early postoperative eating and shorter postoperative hospital stay. The incidence of postoperative complications is similar to that of open surgery. Laparoscopic radical nephrectomy for the treatment of T2 renal cell carcinoma is safe and feasible .