腹腔镜外科杂志2011，Vol.16Issue(9)：711-714,4.
不同保留肾单位术式治疗局限性肾癌临床效果的对比研究
The comparative study on clinical effects of different nephron-sparing surgical methods for localized renal carcinoma
霍立志 1井汉国 1史本康 2石汝骥 1王腾春 1程镇 1马天加3
作者信息
- 1. 泰山医学院附属聊城市第二人民医院,山东临清,252600
- 2. 山东大学齐鲁医院
- 3. 山东大学第二医院
- 折叠
摘要
Abstract
Objective:To compare the clinical effect of three different nephron-sparing surgical methods including peritoneal laparoscopy, retroperitoneal laparoscopy and open surgery for localized renal carcinoma. Methods: The clinical data of 67 patients with localized renal carcinoma was retrospectively analyzed. According to the methods of operation,they were divided into three groups,group A: 22 patients underwent peritoneal laparoscopic excision, group B:21 patients underwent retroperitoneal laparoscopic excision and group C:24 patients underwent open surgery. The operating time, renal warm ischemia time,blood loss,hospital stay,postoperative recurrence and metastasis were compared among the three groups and were statistically analyzed. Results:All of the operations were successful. 63 specimens were proved clear cell carcinoma and 4 specimens were proved granular cell carcinoma by pathology examination. All of them were in renal capsule and the margin tissues were negative. The operation time of group A, group B and group C were (118.7 ±27.9) min, (110. 8 ± 26. 5) min and ( 106.4 ± 25. 5) min respectively. There was no statistically significant difference in them (P>0.05). Renal warm ischemia time were (24.2 ± 13. 1) min, (23. 6 ± 12.9) min and (14.2±4.5) min respectively. The volumes of blood loss were (125.4 ±42.0) ml,(116.5 ±37. 3) ml and (254. 6 ± 128. 5) ml respectively. The time of hospital stay were (11.2 ±3.0) d, (10. 1 ±1.8) d and (16.2±3.2) d respectively. There was statistically significant difference in group C vs group A and group B in the three terms above ( P < 0. 05) and there was no statistically significant difference between group A and group B (P > 0.05). All of the patients were followed up 8 to 60 months, 1 case of tumor local recurrence in group B and 1 case of solitary pulmonary metastasis in group C were found. They were cured by re-operation. There was no statistically significant difference a-mong the three groups (P > 0.0167). Conclusions: Peritoneal laparoscopic and retroperitoneal laparoscopic nephron-sparing surgery for localized renal carcinoma have the advantages of minimal invasion,quick recovery and equal clinical effect with open surgery,and can substitute for open surgery.关键词
肾肿瘤/保留肾单位手术/腹腔镜检查/经腹腔径路/腹膜后径路/对比研究Key words
Kidney neoplasms/ Nephron-sparing surgery/ Laparoscopy/ Peritoneal approach/ Retroperitoneal approach/ Compar-ative study分类
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霍立志,井汉国,史本康,石汝骥,王腾春,程镇,马天加..不同保留肾单位术式治疗局限性肾癌临床效果的对比研究[J].腹腔镜外科杂志,2011,16(9):711-714,4.
