| 摘要: |
| 目的 比较经腹腔和经后腹膜途径行腹腔镜肾癌根治术的临床效果。方法 回顾性分析258例分别经腹腔（n=116）或后腹膜(n=142)方式行腹腔镜下肾癌根治术的肾癌患者临床资料，比较2组术中手术时间、出血量、术后禁食时间及住院时间。结果 经腹腹腔镜组手术时间为80~315 min，平均(167±66.8) min；经后腹膜腹腔镜组为85~280 min，平均(152±48.8) min，二者差异有统计学意义(P=0.034)。经腹腹腔镜组术中出血50~1 000 ml，平均(181±140.4) ml；经后腹膜腹腔镜组为50~800 ml，平均(171±132.9) ml，差异无统计学意义(P=0.544)。经腹腹腔镜组术后禁食时间为术后1～5 d，平均为术后(2.8±1.3) d；经后腹膜腹腔镜组为术后1~5 d，平均为术后(2.9±1.2) d，差异无统计学意义(P=0.801)。经腹腹腔镜组术后住院3～9 d，平均(6.6±1.5) d；经后腹膜腹腔镜组为3～8 d，平均(6.5±1.6) d，差异无统计学意义(P=0.477)。结论经腹腹腔镜和经后腹膜腹腔镜肾癌根治术均有良好效果，且经腹腹腔镜肾癌根治术适用于体积较大的肿瘤。 |
| 关键词: 肾肿瘤 腹腔镜根治性肾切除术 经腹途径 后腹膜途径 |
| DOI：10.3724/SP.J.1008.2011.0938 |
| 投稿时间：2011-06-22修订日期：2011-07-13 |
| 基金项目:上海市市级医院新兴前沿技术联合攻关项目(SHDC12010115)，上海市重点学科项目. |
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| Transperitoneal versus retroperitoneal laparoscopic radical nephrectomy: a comparison of clinical outcomes |
| XU Zun-li△,WANG Lin-hui△,CHEN Wei,YANG Qing,LIU Bing,WU Zhen-jie,SHENG Hai-bo,SUN Ying-hao* |
(Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
△Co-first authors.
*Corresponding author.) |
| Abstract: |
| ObjectiveTo compare clinical outcomes of transperitoneal and retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma (RCC) and to identify the indicators for each approach. MethodsA total of 258 patients underwent transperitoneal(n=116) or retroperitoneal(n=142) laparoscopic radical nephrectomy for RCC. The operation time, blood loss during operation, fasting period after surgery and hospital stay were compared between the two groups. ResultsThe operation time was 80-315 min(a mean of \[167±66.8\] min) for transperitoneal approach and 85-280 min(a mean of \[152±48.8\] min) for retroperitoneal approach(P=0.034).The blood loss was 50-1,000 ml (a mean of \[181±140.4\] ml) for transperitoneal approach and 50-800 ml(a mean of \[171±132.9\] ml) for retroperitoneal approach(P=0.544). The fasting period of surgery was 1-5 d (a mean of \[2.8±1.3\] d) for transperitoneal approach and 1-5 d (a mean of \[2.9±1.2\] d) for retroperitoneal approach(P=0.801). The hospital stay was 3-9 d (a mean of \[6.6±1.5\] d) for transperitoneal approach and 3-8 d (a mean of \[6.5±1.6\] d) for retroperitoneal approach(P=0.477). ConclusionTransperitoneal and retroperitoneal approaches both can yield satisfactory surgical outcomes in laparoscopic radical nephrectomy. The transperitoneal approach is suitable for tumors with a larger size. |
| Key words: kidney neoplasms laparoscopic radical nephrectomy transperitoneal approach retroperitoneal approach |
