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目的探讨后腹腔镜下根治性肾切除术的疗效及安全性。方法选取2013年1月至2015年6月于鞍山市肿瘤医院术前确诊为肾癌的患者83例,根据手术方式将其分为A组、B组和C组,3组分别采用后腹腔镜下根治性肾切除术、单切口后腹腔镜根治性肾切除术和开放肾切除术,各组分别为36例、20例和27例。比较3组患者手术时间、术中出血量、肠道功能恢复时间、住院时间及术后并发症发生情况,对所有患者进行12个月的随访,观察其预后情况。结果 A组患者手术时间明显短于B组、C组,差异有统计学意义(P<0.05),B组与C组比较差异无统计学意义(P>0.05);A、B组患者胃肠功能恢复时间、住院时间均显著短于C组,术中出血量均明显少于C组,差异均有统计学意义(均P<0.05),但A组与B组比较差异均无统计学意义(均P>0.05);A、B组各1例患者发生皮下气肿,并发症发生率为2.8%和5.0%;C组5例出现切口感染,并发症发生率为18.5%,3组患者并发症发生率差异有统计学意义(P<0.05)。结论后腹腔镜肾癌根治术无论是单孔还是多孔操作在肾癌患者治疗中均疗效显著,具有安全性高、创伤小、恢复快、术中及术后并发症少等优点。
Objective To investigate the efficacy and safety of retroperitoneoscopic radical nephrectomy. Methods From January 2013 to June 2015, 83 patients with renal cell carcinoma were diagnosed preoperatively in Anshan Cancer Hospital. According to the surgical methods, they were divided into group A, group B and group C. Three groups were treated with retroperitoneal laparoscopy Under radical nephrectomy, single-incision laparoscopic radical nephrectomy and open nephrectomy, 36 cases in each group, 20 cases and 27 cases. The operation time, intraoperative blood loss, intestinal function recovery time, hospitalization time and postoperative complications were compared between the three groups. All patients were followed up for 12 months and the prognosis was observed. Results The operation time of group A was significantly shorter than that of group B and group C (P <0.05), but there was no significant difference between group B and group C (P> 0.05) Function recovery time and hospitalization time were significantly shorter than group C, blood loss were significantly less than the C group, the difference was statistically significant (all P <0.05), but the difference between group A and group B was not statistically significant (All P> 0.05). One case of subcutaneous emphysema occurred in group A and group B, the complication rates were 2.8% and 5.0% respectively. In group C, 5 cases had incision infection and the complication rate was 18.5% Complication rates were significantly different (P <0.05). Conclusions Retroperitoneal laparoscopic radical nephrectomy, both single-hole and multi-hole operation, has significant curative effect in the treatment of patients with renal cell carcinoma, which has the advantages of high safety, less trauma, faster recovery, fewer intraoperative and postoperative complications.