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目的探讨后腹腔镜在肾癌、肾盂癌治疗中的手术方法及疗效。方法回顾性分析2004年1月至2009年4月间我院应用后腹腔镜技术行肾癌根治术和肾盂癌根治术的患者共254例,进行手术时间、出血量、中转开放情况、术中及术后并发症、住院时间、下床活动时间、术后肿瘤复发及转移例数等数据的统计,对术中操作步骤及手术经验进行总结。结果平均手术时间为(146±64)min,平均出血量为(230±120)ml,中转开放患者为29例(11.4%),术中出现并发症的患者24例(9.4%),术后出现并发症的患者14例(5.5%),平均住院时间(8±2)d,下床活动时间(3.0±1.2)d。术后随访4～46个月,在随访期内肿瘤复发及转移者19例(7.5%)。结论后腹腔镜在上尿路肿瘤的治疗中具有创伤小、解剖层次清晰、术中出血少、术后恢复快等优势,治疗效果与开放手术相似。
Objective To investigate the surgical method and effect of retroperitoneal laparoscopy in the treatment of renal cell carcinoma and renal pelvis carcinoma. Methods A total of 254 patients undergoing laparoscopic radical nephrectomy and radical nephrectomy in our hospital from January 2004 to April 2009 were retrospectively analyzed. The operative time, bleeding volume, And postoperative complications, hospital stay, time to bed activity, tumor recurrence and metastasis after surgery and other data statistics, operation procedures and surgical experience were summarized. Results The average operation time was (146 ± 64) min and the mean bleeding volume was (230 ± 120) ml. Twenty-nine patients (11.4%) underwent open surgery and 24 patients (9.4%) had intraoperative complications. There were 14 patients (5.5%) with complications, the average length of hospital stay (8 ± 2) d, and the time to bed ambulation (3.0 ± 1.2) d. The patients were followed up for 4 to 46 months. Tumor recurrence and metastasis were observed in 19 (7.5%) patients during the follow-up period. Conclusions Retroperitoneal laparoscopy has the advantages of small trauma, clear anatomy, less intraoperative bleeding and faster postoperative recovery in the treatment of upper urinary tract tumors. The treatment effect is similar to that of open surgery.