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目的:探究在保留肾单位手术中3D腹腔镜与传统腹腔镜的疗效对比。方法:对郑州大学第一附属医院泌尿外科2015年2月~2015年6月需进行保留肾单位手术治疗的T1a期肾癌患者按照随机原则进行随机分配,3D腹腔镜手术组36例,同期行传统腹腔镜手术组37例,观察并比较二组在手术时间、术中热缺血时间、术中出血量、术后胃肠道功能恢复时间、引流管留置时间、术后住院时间及术后复发情况(术后随访2~3个月,复查CT)等方面的差异。结果:所有手术均顺利完成,无中转开放,术后病理均未发现切缘阳性,术后随访3个月均未出现复发。3D腹腔镜组和传统腹腔镜组手术时间分别为(83±34)min和(115±40)min,术中热缺血时间分别为(16±7)min和(25±5)min,两组数据比较差异有统计学意义(P<0.05),术中出血量分别为(185±40)ml和(189±32)ml,术后胃肠道功能恢复时间(2.0±1.0)d和(2.5±0.5)d,术后拔除引流管时间为(3.6±0.7)d和(3.5±1.0)d,术后住院时间为(6.0±1.5)d和(7.0±1.0)d,两组数据比较差异无统计学意义(P>0.05)。结论:3D腹腔镜保留肾单位手术是一种安全、可靠的手术方式,与传统腹腔镜方式相比,其具有手术时间短、明显减少热缺血时间等优势,同时3D腹腔镜清晰逼真,明显增加术者操作灵活性,同时手术费用并无明显增加,因此具有较佳的治疗效果和推广意义。
OBJECTIVE: To investigate the efficacy of 3D laparoscopy versus conventional laparoscopy in the preservation of nephron surgery. Methods: Patients with stage T1a renal cell carcinoma who underwent nephron sparing surgery in the Department of Urology, the First Affiliated Hospital of Zhengzhou University from February 2015 to June 2015 were randomized according to the randomized principle. 36 patients underwent 3D laparoscopic surgery, 37 cases of traditional laparoscopic surgery group were observed and compared in the operation time, intraoperative warm ischemia time, intraoperative blood loss, postoperative gastrointestinal function recovery time, drainage tube indwelling time, postoperative hospital stay and postoperative Recurrence (postoperative follow-up of 2 to 3 months, review CT) and other differences. Results: All the operations were successfully completed, no transit was found, and no positive margins were found after surgery. No recurrence occurred after 3 months of follow-up. The operation time of 3D laparoscopic group and conventional laparoscopic group were (83 ± 34) min and (115 ± 40) min respectively, and the durations of warm ischemia were (16 ± 7) min and (25 ± 5) min respectively There was significant difference between the two groups (P <0.05). The mean amount of bleeding during operation were (185 ± 40) ml and (189 ± 32) ml respectively, postoperative gastrointestinal function recovery time (2.0 ± 1.0) 2.5 ± 0.5) d. The drainage time of the drainage tube after operation was (3.6 ± 0.7) days and (3.5 ± 1.0) days, and the postoperative hospital stay was (6.0 ± 1.5) days and (7.0 ± 1.0) days respectively The difference was not statistically significant (P> 0.05). CONCLUSION: 3D laparoscopic nephron surgery is a safe and reliable method of operation. Compared with the traditional laparoscopic approach, it has the advantages of short operation time, significantly reducing the time of thermal ischemia and the like, and 3D laparoscopy is vivid and vivid Increasing surgeons operating flexibility, while surgery costs did not significantly increase, so has a better therapeutic effect and promotion of significance.