保留肾单位解剖程序化后腹腔镜肾部分切除术治疗局限性肾癌的效果良好
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摘要
目的:研究保留肾单位解剖程序化后腹腔镜肾部分切除术(RLPN)治疗局限性肾癌(LRCC)患者的临床效果。方法:68例LRCC患者,随机分为对照组和研究组,每组34例。对照组采用开放肾部分切除术(OPN)治疗,研究组采用解剖程序化RLPN治疗。比较两组手术时长、肾脏热缺血时间及术后3个月生存质量等观察指标。结果:研究组术中出血量少于对照组,术后引流管留置、胃肠道功能恢复及术后住院等时间均短于对照组,差异有统计学意义(P<0.05);研究组术后并发症总发生率14.71%,低于对照组的32.35%,但差异无统计学意义(P>0.05);术后3个月,研究组生存质量改善率94.12%,高于对照组的73.53%(P<0.05)。结论:解剖程序化RLPN治疗LRCC患者能有效提高治疗效果,改善患者预后。
Objective: To study the clinical effect of programmed retroperitoneal laparoscopic partial nephrectomy(RLPN)with nephron sparing in the treatment of localized renal cell carcinoma(LRCC). Methods: 68 patients with LRCC were randomly divided into control group and study group, with 34 cases in each group. The control group was treated with open partial nephrectomy(OPN), and the study group was treated with anatomical programmed RLPN. The observational indexes such as the length of operation, the time of warm ischemia of the kidney and the quality of life after 3 months were compared. Results: The amount of intraoperative blood loss was lower in the study group than in the control group. The time of postoperative drainage tube retention, gastrointestinal function recovery, and postoperative hospital stay in the study group was shorter than that in the control group. The difference was statistically significant(P<0.05). The total incidence of postoperative complications was 14.71%, which was lower than 32.35% of the control group, but the difference was not statistically significant(P>0.05). After 3 months, the survival quality improvement rate of the study group was 94.12%, which was higher than 73.53% of the control group(P<0.05). Conclusion: Anatomical programmed RLPN in patients with LRCC can effectively improve the treatment effect and improve the prognosis of patients.
Objective: To study the clinical effect of programmed retroperitoneal laparoscopic partial nephrectomy(RLPN)with nephron sparing in the treatment of localized renal cell carcinoma(LRCC). Methods: 68 patients with LRCC were randomly divided into control group and study group, with 34 cases in each group. The control group was treated with open partial nephrectomy(OPN), and the study group was treated with anatomical programmed RLPN. The observational indexes such as the length of operation, the time of warm ischemia of the kidney and the quality of life after 3 months were compared. Results: The amount of intraoperative blood loss was lower in the study group than in the control group. The time of postoperative drainage tube retention, gastrointestinal function recovery, and postoperative hospital stay in the study group was shorter than that in the control group. The difference was statistically significant(P<0.05). The total incidence of postoperative complications was 14.71%, which was lower than 32.35% of the control group, but the difference was not statistically significant(P>0.05). After 3 months, the survival quality improvement rate of the study group was 94.12%, which was higher than 73.53% of the control group(P<0.05). Conclusion: Anatomical programmed RLPN in patients with LRCC can effectively improve the treatment effect and improve the prognosis of patients.
引文
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[11] 高海捷,吴大鹏,朱国栋,等.后腹腔镜肾部分切除术与开放肾部分切除治疗局限性肾癌的安全性及疗效比较[J].现代泌尿外科杂志,2016,21(3):182-186.
[12] 贺胜龙,孙浩.两种手术方法治疗局限性肾癌的生存分析[J].中国医学创新,2016,13(26):5-9.
[13] 宋萍伟,丛超,王平,等.解剖程序化后腹腔镜肾部分切除术器械护士的医护合作培训探讨[J].国际护理学杂志,2015,34(22):3144-3147.
[14] 包国昌,李春生,李海峰,等.解剖程序化后腹腔镜肾部分切除术治疗局限性肾癌疗效分析[J].内蒙古医学杂志,2017,49(08):11-14.
[15] 刘畅.腹腔镜肾部分切除术与开放性肾部分切除术治疗老年局限性肾癌的近期疗效及安全性[J].中国实用医刊,2018,45(7):74-76.
[2] WANG C,CHEN Z,DONG J,et al.Prognostic significance of body mass index in patients with localized renal cell carcinoma[J].Int Braz J Urol,2018,44(6):1147-1155.
[3] 魏礼杰,庞诗语,罗扬,等.肾部分切除术与肾癌根治术治疗局限性肾癌的预后比较的[J].现代泌尿外科杂志,2015,20(6):402-408.
[4] TSIVIAN M,ABERN M R,TSIVIAN E,et al.Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell csarcinoma[J].Urol Oncol,2018,36(8):362.e1-362.e7.
[5] 孙建涛,霍庆祥,杨金辉,等.解剖程序化后腹腔镜下肾部分切除术94例[J].实用医学杂志,2016,32(1):108-110.
[6] 刘世敏,刘述成,李清.RNA干扰抑制细胞外基质COL6A1基因表达对肾癌786-0细胞增殖和侵袭的影响[J].中南医学科学杂志,2018,46(3):58-62.
[7] MUNOZ-RODRIGUEZ J,PRERA A,DOMINGUEZ A,et al.Laparoscopic partial nephrectomy:Comp-arative study of the transperitoneal pathway and the retroperitoneal pathway[J].Actas Urol Esp,2018,42(4):273-279.
[8] 孙建涛,霍庆祥,杨金辉,等.解剖程序化后腹腔镜下肾部分切除术94例[J].实用医学杂志,2016,32(1):108-110.
[9] HU Z F,LV S D,HUANG J F,et al.Three-dimensional spatial measurement versus conventional CT planning in laparoscopic partial nephrectomy for renal tumors[J].Acta Univ Med Nanjing,2018,38(5):606-611.
[10] 丁全明,梁伟,王刚,等.早期局限性肾癌手术治疗效果的回顾性分析比较[J].国际医药卫生导报,2017,23(20):3219-3222.
[11] 高海捷,吴大鹏,朱国栋,等.后腹腔镜肾部分切除术与开放肾部分切除治疗局限性肾癌的安全性及疗效比较[J].现代泌尿外科杂志,2016,21(3):182-186.
[12] 贺胜龙,孙浩.两种手术方法治疗局限性肾癌的生存分析[J].中国医学创新,2016,13(26):5-9.
[13] 宋萍伟,丛超,王平,等.解剖程序化后腹腔镜肾部分切除术器械护士的医护合作培训探讨[J].国际护理学杂志,2015,34(22):3144-3147.
[14] 包国昌,李春生,李海峰,等.解剖程序化后腹腔镜肾部分切除术治疗局限性肾癌疗效分析[J].内蒙古医学杂志,2017,49(08):11-14.
[15] 刘畅.腹腔镜肾部分切除术与开放性肾部分切除术治疗老年局限性肾癌的近期疗效及安全性[J].中国实用医刊,2018,45(7):74-76.