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目的对比后腹腔镜联合电切镜与传统开放手术治疗肾盂肿瘤的效果与安全性。方法按照手术方法不同,将2008年1月—2016年1月间台州市中心医院行手术的102例肾盂肿瘤患者分成观察组与对照组,观察组采用后腹腔镜联合电切治疗,对照组采用传统开放手术治疗。分别比较2组的术中出血量、手术时间、术后肛门恢复通气时间、术后留置引流管时间、术后首次下床活动、住院时间等各项指标,观察2组的术后并发症。术后随访,包括病史、尿液分析、肝肾功能、彩超、胸部X线片、膀胱镜等内容,观察1年内的转移和复发情况(发现膀胱癌情况)。对数据进行统计学分析,进而分析后腹腔镜联合电切镜术治疗肾盂肿瘤的效果与安全性。结果观察组的术中出血量、手术时间、术后肛门恢复通气时间、术后留置引流管时间、术后首次下床活动、住院时间明显短于对照组,比较差异具有统计学意义(P<0.05);观察组并发症率为4.41%,显著低于对照组的20.59%(P<0.05);术后随访1年,2组患者的肿瘤局部复发率、皮肤切口转移率以及远处肿瘤转移率差异没有统计学意义(P>0.05)。结论腹腔镜联合电切镜治疗肾盂肿瘤有效地减少了手术创伤,促进了术后恢复,降低了并发症的发生率。
Objective To compare the efficacy and safety of retroperitoneal laparoscopic resectoscope with traditional open surgery for renal pelvis tumors. Methods According to the different surgical methods, 102 patients with renal pelvis and tumor who underwent surgery from January 2008 to January 2016 in Taizhou Central Hospital were divided into observation group and control group. The observation group was treated with retroperitoneal laparoscopic combined with electrotomy. The control group Traditional open surgery. The postoperative complications of the two groups were compared between the two groups in the amount of bleeding, operation time, postoperative anus recovery ventilation time, postoperative indwelling drainage tube time, the first ambulation after surgery, hospitalization time and other indicators. Postoperative follow-up, including history, urine analysis, liver and kidney function, color Doppler ultrasonography, chest X-ray, cystoscopy and other content, observe the metastasis and recurrence within 1 year (found bladder cancer). The data were statistically analyzed, and then analyzed the effect and safety of retroperitoneal laparoscopic combined with resectoscopy in the treatment of renal pelvis tumors. Results The intraoperative blood loss, operation time, postoperative anus recovery ventilation time, postoperative indwelling drainage tube, the first time after bed activity and hospitalization time in the observation group were significantly shorter than those in the control group (P < 0.05). The complication rate of the observation group was 4.41%, which was significantly lower than that of the control group (20.59%, P <0.05). After 1 year follow-up, the local recurrence rate, skin incision metastasis rate and distant metastasis Rate difference was not statistically significant (P> 0.05). Conclusions Laparoscopic combined with resectoscope for the treatment of renal pelvis tumors can effectively reduce the surgical trauma, promote postoperative recovery and reduce the incidence of complications.