后腹腔镜下分支肾动脉序贯阻断肾部分切除术在多发肾肿瘤患者中的应用
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摘要
目的探索后腹腔镜下分支肾动脉序贯阻断肾部分切除术在多发肾肿瘤患者中临床价值。方法选取2014年1月至2018年1月本院诊治的多发性肾肿瘤患者80例,分别采用传统肾部分切除术和后腹腔镜下分支肾动脉序贯阻断肾部分切除术治疗,分析对比两组住院指标及手术指标,观察两组的并发症及不良反应。结果实验组的阻断时间及出血量明显低于对照组,差异有统计学意义(P<0.05);实验组的手术用血与引流量与对照组比较,差异无统计学意义。实验组肛门排气时间、住院时间、术后恢复时间及术后置管时间明显低于对照组,差异有统计学意义(P<0.05)。实验组的术后肾功能水平与对照组比较,差异无统计学意义。实验组术后并发症明显低于对照组,差异有统计学意义(P<0.05)。结论后腹腔镜下分支肾动脉序贯阻断肾部分切除术治疗多发性肾肿瘤具有较高的临床疗效,不过大影响肾功能,有效降低并发症,具有重要的临床价值。
Objective To explore the clinical value of retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion in patients with multiple renal tumors. Methods 80 patients with multiple renal tumors from January 2014 to January 2018 were treated with traditional partial nephrectomy and retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion. The hospitalization index and operation index were analyzed and compared. The complications and adverse reactions of the two groups were observed. Results The blocking time and bleeding volume of the experimental group were significantly lower than those of the control group(P<0.05), and the difference was statistically significant(P<0.05). The anal exhaust time, hospitalization time, postoperative recovery time and postoperative catheterization time in the experimental group were significantly lower than those in the control group(P<0.05). There was no significant difference in renal function between the experimental group and the control group. Postoperative complications in the experimental group were significantly lower than those in the control group,the difference was statistically significant(P<0.05). Conclusion Retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion has a high clinical efficacy in the treatment of multiple renal tumors, but it greatly affects renal function and effectively reduces complications.
Objective To explore the clinical value of retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion in patients with multiple renal tumors. Methods 80 patients with multiple renal tumors from January 2014 to January 2018 were treated with traditional partial nephrectomy and retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion. The hospitalization index and operation index were analyzed and compared. The complications and adverse reactions of the two groups were observed. Results The blocking time and bleeding volume of the experimental group were significantly lower than those of the control group(P<0.05), and the difference was statistically significant(P<0.05). The anal exhaust time, hospitalization time, postoperative recovery time and postoperative catheterization time in the experimental group were significantly lower than those in the control group(P<0.05). There was no significant difference in renal function between the experimental group and the control group. Postoperative complications in the experimental group were significantly lower than those in the control group,the difference was statistically significant(P<0.05). Conclusion Retroperitoneal laparoscopic partial nephrectomy with branch renal artery occlusion has a high clinical efficacy in the treatment of multiple renal tumors, but it greatly affects renal function and effectively reduces complications.
引文
[1]周东.腹腔镜与传统手术在肾动脉分支阻断肾部分切除术治疗肾肿瘤中的运用分析[J].中国医药导报,2014,11(2):85-87.
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[6] Liu W, Chen M, Zu X, et al. The use of self-retaining barbed suture preserves superior renal function during laparoscopicpartial nephrectomy:a PADUA score matched comparison[J]. J Laparoendosc Adv Surg Tech A, 2015,25(2):130-134.
[7]邵鹏飞,殷长军,孟小鑫,等.后腹腔镜下肾部分切除术治疗肾肿瘤的疗效评价[J].中华泌尿外科杂志,2010,31(10):658-661.
[8] Satkunasivam R, Tsai S, Syan S, et a1. Robotic unclamped”minimal—margin”partial nephrectomy:ongoing refinement of the anatomic zero. ischemia concept[J].Eur Urol, 2015,68:705-712.
[9] Domínguez A, Bellido JA, Mu oz-Rodríguez J, et al.Retro peritonealand transperitoneal laparoscopic cryotherapy for small renal masses[J]. Actas Urol Esp, 2015,39(9):582-587.
[10]孟一森,范宇,李德润,等.后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析[J].中华泌尿外科杂志,2013,34(11):805-809.
[11]陈帅,胡卫列.肾部分切除术术前评分系统的临床应用和研究进展[J].中华泌尿外科杂志,2015,36(5):390-393.
[12]陈勇辉,吴小荣,陈伟,等.后腹腔镜下肾部分切除术在完全内生型肾肿瘤治疗中的应用[J].中华泌尿外科杂志,2016,37(10):726-729.
[2]刘亮,赵晓风.后腹腔镜肾部分切除术与开放手术治疗肾肿瘤的手术疗效比较[J].中国临床医生杂志,2016,44(3):68-70.
[3]吴永超.腹腔镜手术与开放性肾脏部分切除术对肾脏肿瘤疗效比较[J].中国临床医生,2014,42(1):60-62.
[4] Bowlin PR, Farhat WA. Laparoscopic nephrectomy and partial nephrectomy:intraperitoneal,retroperitoneal,single site[J]. Urol Clin North Am, 2015,42(1):31-42.
[5]刘茁,孟一森,范宇,等.后腹腔镜下肾部分切除术治疗内生型肾肿瘤的l临床分析[J].中华泌尿外科杂志,2015,36(10):726-731.
[6] Liu W, Chen M, Zu X, et al. The use of self-retaining barbed suture preserves superior renal function during laparoscopicpartial nephrectomy:a PADUA score matched comparison[J]. J Laparoendosc Adv Surg Tech A, 2015,25(2):130-134.
[7]邵鹏飞,殷长军,孟小鑫,等.后腹腔镜下肾部分切除术治疗肾肿瘤的疗效评价[J].中华泌尿外科杂志,2010,31(10):658-661.
[8] Satkunasivam R, Tsai S, Syan S, et a1. Robotic unclamped”minimal—margin”partial nephrectomy:ongoing refinement of the anatomic zero. ischemia concept[J].Eur Urol, 2015,68:705-712.
[9] Domínguez A, Bellido JA, Mu oz-Rodríguez J, et al.Retro peritonealand transperitoneal laparoscopic cryotherapy for small renal masses[J]. Actas Urol Esp, 2015,39(9):582-587.
[10]孟一森,范宇,李德润,等.后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析[J].中华泌尿外科杂志,2013,34(11):805-809.
[11]陈帅,胡卫列.肾部分切除术术前评分系统的临床应用和研究进展[J].中华泌尿外科杂志,2015,36(5):390-393.
[12]陈勇辉,吴小荣,陈伟,等.后腹腔镜下肾部分切除术在完全内生型肾肿瘤治疗中的应用[J].中华泌尿外科杂志,2016,37(10):726-729.