后腹腔镜下肾部分切除术治疗肾肿瘤的临床分析(1)
[摘要] 目的 研究应用后腹腔镜下肾部分切除术治疗肾肿瘤患者在临床上的安全性和疗效的确切性及对生存质量的影响。 方法 选取本院2014年6月～2015年10月间收治的70例肾肿瘤患者，35例采用后腹腔镜下肾部分切除术为观察组，另35例采用传统开放肾部分切除术为对照组。比较两组术后住院天数、手术时间、术中出血量、热缺血时间及并发症发生情况。 结果 所有手术均成功，无一例失败。观察组的住院时间、手术时间、术中出血量均少于对照组，而术中平均热缺血明显高于对照组，两组差异有高度统计学意义(P<0.01)。对照组并发症6例，观察组为1例，两组并发症亦有明显差异。 结论 临床上应用后腹腔镜下肾部分切除术疗效确切，值得深入研究并推广。
[关键词] 后腹腔镜；肾脏肿瘤；肾部分切除术；安全性
[中图分类号] R737.11 [文献标识码] B [文章编号] 1673-9701(2016)17-0041-03
Clinical analysis of laparoscopic partial nephrectomy in treatment of renal cancer
SUN Aijun
Urinary Surgery Department， Anshan Tumor Hospital in Liaoning Province， Anshan 114033， China
[Abstract] Objective To explore the clinical safety and efficacy and its influence on quality of life of laparoscopic partial nephrectomy in treatment of renal cancer. Methods 70 cases of renal cancer patients were selected in our hospital from June 2014 to October 2015， 35 cases with laparoscopic partial nephrectomy were as observation group， the other 35 cases with traditional open partial nephrectomy were as the control group. During the course of treatment， the postoperative hospitalization days，operation time，intraoperative blood loss，warm ischemia time and complications were compared. Results All operations were successful，no failure.Length of hospital stay， operation time and intraoperative blood loss in observation group were less than the control group，patients with ischemia and intraoperative average was significantly higher than that of control group(P<0.01). There were 6 cases with complication in control group， while only 1 case in observation group. Two groups had significant difference in complications. Conclusion After the clinical application of laparoscopic partial nephrectomy may have higher security，curative effect and is worth further research and promotion.
[Key words] After laparoscopic； Kidney tumor； Renal resection； Security
肾脏肿瘤是泌尿科室一种常见的疾病，癌细胞源于肾实质泌尿小管上皮系统。随着现代医疗水平的提高，实际上肾脏的小肿瘤检出率是较高的，及时发现并进行切除能够明显提高患者的生存期和生存质量。对于直径<4 cm的肿瘤，进行局部切除已在临床上达到共识，然而切除术具有一定风险，并可能引起一些并发症。这些热点问题已成为目前医师们更为关注的议题[1-3]，目前更为理想的切除术为后腹腔镜下行肾部分切除术(laparoscopic partial nephrectomy，LPN)，本文就其与传统开放肾部分切除术(open partial ne-phrectomy，OPN)相比，探讨其临床效果，现报道如下。
1 资料与方法
1.1 一般资料
选取本院2014年6月～2015年10月间收治的70例肾肿瘤患者，随机选取35例采用后腹腔镜下肾部分切除术为观察组，另35例采用传统开放肾部分切除术为对照组。对照组男女比例为24∶11，平均年龄(40.2±7.2)岁，左侧19例，右侧16例，肿瘤直径平均(3.31±0.33)cm，肾细胞癌TNM分期：T1aN0M0 20例，T1bN0M0 15例；观察组男女比例25∶10，平均年龄(41.3±6.9)岁，左侧18例，右侧17例，肿瘤直径平均(3.26±0.40)cm，肾细胞癌TNM分期：T1aN0M0 19例，T1bN0M0 16例。两组各项基本临床资料差异均无统计学意义(P>0.05)，具有可比性。每位患者及家属均在充分知情同意的前提下签署同意书[4，5]。, 百拇医药(孙爱军)
[关键词] 后腹腔镜；肾脏肿瘤；肾部分切除术；安全性
[中图分类号] R737.11 [文献标识码] B [文章编号] 1673-9701(2016)17-0041-03
Clinical analysis of laparoscopic partial nephrectomy in treatment of renal cancer
SUN Aijun
Urinary Surgery Department， Anshan Tumor Hospital in Liaoning Province， Anshan 114033， China
[Abstract] Objective To explore the clinical safety and efficacy and its influence on quality of life of laparoscopic partial nephrectomy in treatment of renal cancer. Methods 70 cases of renal cancer patients were selected in our hospital from June 2014 to October 2015， 35 cases with laparoscopic partial nephrectomy were as observation group， the other 35 cases with traditional open partial nephrectomy were as the control group. During the course of treatment， the postoperative hospitalization days，operation time，intraoperative blood loss，warm ischemia time and complications were compared. Results All operations were successful，no failure.Length of hospital stay， operation time and intraoperative blood loss in observation group were less than the control group，patients with ischemia and intraoperative average was significantly higher than that of control group(P<0.01). There were 6 cases with complication in control group， while only 1 case in observation group. Two groups had significant difference in complications. Conclusion After the clinical application of laparoscopic partial nephrectomy may have higher security，curative effect and is worth further research and promotion.
[Key words] After laparoscopic； Kidney tumor； Renal resection； Security
肾脏肿瘤是泌尿科室一种常见的疾病，癌细胞源于肾实质泌尿小管上皮系统。随着现代医疗水平的提高，实际上肾脏的小肿瘤检出率是较高的，及时发现并进行切除能够明显提高患者的生存期和生存质量。对于直径<4 cm的肿瘤，进行局部切除已在临床上达到共识，然而切除术具有一定风险，并可能引起一些并发症。这些热点问题已成为目前医师们更为关注的议题[1-3]，目前更为理想的切除术为后腹腔镜下行肾部分切除术(laparoscopic partial nephrectomy，LPN)，本文就其与传统开放肾部分切除术(open partial ne-phrectomy，OPN)相比，探讨其临床效果，现报道如下。
1 资料与方法
1.1 一般资料
选取本院2014年6月～2015年10月间收治的70例肾肿瘤患者，随机选取35例采用后腹腔镜下肾部分切除术为观察组，另35例采用传统开放肾部分切除术为对照组。对照组男女比例为24∶11，平均年龄(40.2±7.2)岁，左侧19例，右侧16例，肿瘤直径平均(3.31±0.33)cm，肾细胞癌TNM分期：T1aN0M0 20例，T1bN0M0 15例；观察组男女比例25∶10，平均年龄(41.3±6.9)岁，左侧18例，右侧17例，肿瘤直径平均(3.26±0.40)cm，肾细胞癌TNM分期：T1aN0M0 19例，T1bN0M0 16例。两组各项基本临床资料差异均无统计学意义(P>0.05)，具有可比性。每位患者及家属均在充分知情同意的前提下签署同意书[4，5]。, 百拇医药(孙爱军)