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[目的]比较腹腔镜保留肾单位手术(NSS)与开腹NSS治疗T1a期肾癌的临床疗效.[方法]回顾性分析2014年1月至2015年12月本院收治的74例T1a期肾癌患者的临床资料,根据手术方法将其分为腹腔镜组(n=40)和开腹组(n=34),比较两组手术及术后恢复情况、并发症发生率、切缘阳性率,并测定血浆肌酐(SCr)水平,计算双肾总肾小球滤过率(GRF),门诊或电话随访术后随访7~28个月,记录两组复发转移情况.[结果]两组术后引流时间、切缘阳性率比较差异无统计学意义(P>00.5),腹腔镜组手术时间、肾缺血时间长于开腹组,术中出血量、住院时间短于开腹组,差异有统计学意义(P00.5),术后GFR水平低于术前,差异具有统计学意义(P0.05).腹腔镜组术后并发症发生率为100.%(4/40)低于开腹组的29.41%(10/34),差异有统计学意义(χ2=45.15,P=00.3400.5) .The surgical time and renal ischemia time of the laparoscopic group were longer than those of the laparotomy group ,while the intraoperative blood loss and length of hospital stay were less and shorter than those of the laparotomy control group ( P <00.5) .After surgery ,GFR levels decreased in the two groups ( P 00.5) .The incidence of postop-erative complications was lower in the laparoscopic group than in the laparotomy group (100.% vs 294.1% ) (χ2 =45.15 ,P <00.5) .There was no recurrence or metastasis in the two groups .[Conclusion]The tumor control effect of laparoscopic NSS and open NSS is similar .However ,laparoscopic NSS can shorten the postoperative recovery time and reduce the incidence of postoperative complications .Though the time of renal ischemia is prolonged ,renal damage is not aggravated .