后腹腔镜下零缺血肾肿瘤剜除术的临床疗效认领

Clinical study of retroperitoneal laparoscopic zero-ischemic nephrectomy for renal neoplasm

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摘要目的探讨后腹腔镜下零缺血肾肿瘤剜除术在肾肿瘤临床治疗中的安全性与可行性。方法回顾性分析2016年3月-2019年12月入住笔者医院的42例早期肾癌患者的临床资料,根据手术方式分为零缺血组(研究组)和热缺血组(对照组),比较2组患者的手术时间,术中出血量,住院天数,术后并发症及患肾肌酐清除率。结果所有患者手术均获得成功,完整地切除肿瘤,切缘阳性率为零,研究组患者手术时间为(119.3±16.8) min与对照组的(112.1±15.6) min比较,差异无统计学意义(P>0.05);研究组患者术中出血量和住院时间分别为(250±35) ml和(9.3±1.5) d,对照组依次为(210±28) ml和(9.1±1.7) d,2组间比较,住院天数差异无统计学意义(P>0.05),而术中出血量差异有统计学意义(P<0.05);研究组术后7 d、术后1个月及术后半年患肾肌酐清除率分别为(32.15±11.78)μmol/L、(40.2±5.1)μmol/L及(45.5±7.8) ml/min,对照组依次为(44.15±11.78)μmol/L、(36.1±3.2)μmol/L及(40.3±4.2) ml/min,2组比较差异有统计学意义(P<0.05)。结论后腹腔镜下零缺血肾肿瘤切除术安全性高,具有临床可行性,能最大限度地保护肾功能。 Objective To investigate the safety,efficacy and feasibility of retroperitoneal laparoscopic zero ischemic renal tumor enucleation in the clinical treatment of renal tumors.Methods Retrospectively analyzed in March 2016 to December 2019,during a stay in the hospital uropoiesis surgical department clinical data of 42 patients with early renal cancer,according to the operation method was divided into zero ischemia group(experimental group)and thermal ischemia group(control group),compared two groups of patients,operation time,intraoperative blood loss,hospitalization days,postoperative complications and risk of renal creatinine clearance.Results All patients were successfully resected,and the positive rate of the resection margin was zero.The operation time of the experimental group was(119.3±16.8)min,and that of the control group was(112.1±15.6)min,and the difference was not statistically significant(P>0.05).Intraoperative blood loss and length of stay were(250±35)ml and(9.3±1.5)d,respectively,in the experimental group,and(210±28)ml and(9.1±1.7)d,respectively,in the control group.The difference in length of stay between the two groups was not statistically significant(P>0.05),while intraoperative blood loss was statistically significant(P<0.05).Renal creatinine clearance rates were(32.15±11.78)ml/min、(40.2±5.1)ml/min and(45.5±7.8)ml/min in the experimental group 7 daysone month and six months after surgery,(44.15±11.78)ml/min、(36.1±3.2)ml/min and(40.3±4.2)ml/min in the control group,respectively,with statistically significant differences(P<0.05).Conclusion Retroperitoneal laparoscopic zero ischemia tumor enucleation is safe,clinically feasible and can protect renal function to the greatest extent.

作者闫书贤高燕华邹永强 YANShu-xian;GAO Yan-hua;ZOU Yong-qiang(Department of Urology,No.989th Hospital of PLA,Luoyang,Henan 471031,China)

机构地区解放军第989医院泌尿外科

出处《实用医药杂志》 2021年第1期13-15,20,共4页 Practical Journal of Medicine & Pharmacy

基金洛阳市科研计划项目(1603001A-2)。

关键词肾癌后腹腔镜零缺血 Renal carcinoma Retroperitoneal laparoscopy Zero ischemia

分类号 R295 [医药卫生—民族医学]

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