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目的比较小肾癌手助腹腔镜和开放肾部分切除术的临床效果。方法回顾分析30例行手助腹腔镜肾部分切除术和20例行开放肾部分切除术患者的病例资料,比较两种手术方法的失血量、手术时间、热缺血时间、切缘阳性率、患者住院时间、并发症及手术效果的差异。结果手助腹腔镜组和开放手术组平均肿瘤大小分别为(2.58±0.50)和(2.62±0.60)cm(P>0.05),平均出血量分别为(120.2±38.9)和(353.6±89.6)ml(P<0.01),平均手术时间分别为(158.2±27.6)和(196.2±39.6)min(P<0.05),平均热缺血时间分别为(26.1±3.2)和(35.2±2.8)min(P<0.05),平均住院时间分别为(7.8±2.0)和(12.3±3.0)d(P<0.01),两组的切缘阳性率、并发症发生率均无差异。随访3～28个月,两组均未出现局部复发。结论手助腹腔镜肾部分切除术较开放肾部分切除术手术时间短,出血少,住院时间短,且不增加热缺血时间,手术效果相当。
Objective To compare the clinical efficacy of hand-assisted laparoscopic and open partial nephrectomy in small renal cell carcinoma. Methods A retrospective analysis of 30 cases of hand-assisted laparoscopic partial nephrectomy and 20 cases of open partial nephrectomy in patients with case data, blood loss, operation time, warm ischemia time, positive margins, Patient hospitalization, complications and surgical effects of the difference. Results The mean tumor sizes in hand-assisted laparoscopic and open surgery groups were (2.58 ± 0.50) and (2.62 ± 0.60) cm (P> 0.05), respectively. The mean bleeding volume was 120.2 ± 38.9 and 353.6 ± 89.6 respectively (P <0.01). The mean operative time was (158.2 ± 27.6) and (196.2 ± 39.6) min (P <0.05), and the average time of warm ischemia were (26.1 ± 3.2) and (35.2 ± 2.8) min <0.05). The average length of hospital stay was (7.8 ± 2.0) and (12.3 ± 3.0) days, respectively (P <0.01). There was no difference in the positive rate of the margins and the incidence of complications between the two groups. Followed up for 3 ~ 28 months, no recurrence occurred in both groups. Conclusions Hand-assisted laparoscopic partial nephrectomy is more effective than open partial nephrectomy in short operative time, less bleeding, shorter hospital stay, and no increase of warm ischemic time.