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运用分析.docVIP

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运用分析 　　[摘要] 目的 比较腹膜后腹腔镜与开放性分支肾动脉阻断肾部分切除术治疗肾肿瘤的疗效。 方法 选取丽水市人民医院2010年5月～2013年2月收治的29例肾肿瘤患者，分为两组，腹腔镜组14例，经腹膜后腹腔镜行分支肾动脉阻断肾部分切除术；开放手术组15例，行开放性分支肾动脉阻断肾部分切除术。术后比较两组手术时间、术中出血量、热缺血时间、术后胃肠功能恢复时间、术后住院时间及并发症发生情况。 结果 ①腹腔镜组手术时间[（154±68）min]长于开放手术组[（119±48）min]，差异有统计学意义（P 0.05）；但腹腔镜组热缺血时间[（18.7±6.1）min]、肠道功能恢复时间[（2.1±0.7）d]、术后住院时间[（9.0±1.9）d]及术中出血量[（233±30）mL]均低于开放手术组[（27.1±2.2）min、（3.0±1.4）d、（13.8±3.9）d、（368±49）mL]，差异有统计学意义（P 0.05）。②腹腔镜组1例发生皮下气肿，72 h后自然消退。开放手术组出现3例患者发生切口感染，经换药后均愈合。随访期间均无复发及转移。 结论 腹腔镜治疗肾肿瘤具有安全有效、康复快、术后并发症少等优点。 　　[关键词] 腹腔镜；分支肾动脉；肾肿瘤；开放手术 　　[中图分类号] R737.1 [文献标识码] A [文章编号] 1673-7210（2014）01（b）-0085-03 　　Analysis of the application of laparoscopic operation and traditional operation in the renal artery branches interdict partial nephrectomy for renal tumor 　　ZHOU Dong 　　Department of Urology， Peoples Hospital of Lishui City， Zhejiang Province， Lishui 323000， China 　　[Abstract] Objective To investigate and compare the curative effect of laparoscopic operation and traditional operation in the renal artery branches interdict partial nephrectomy for renal tumor nephrectomy. Methods 29 patients with renal tumor from May 2010 to February 2013 in Peoples Hospital of Lishui City were selected and divided into two groups； 14 cases in laparoscopy group were given the branch renal artery block and partial nephrectomy with retroperitoneal laparoscopy， and 15 cases in open surgery group were treated with open branch renal artery block and partial nephrectomy. The operating time， bleeding volume in the operation， warm ischemia time， postoperative gastrointestinal function recovery time， postoperative hospitalization time and the occurrence of complications in two groups after the operation were compared. Results ①The operating time in laparoscopy group [（154±68） min] was longer than that in open surgery group [（119±48） min]， the difference was statistically significant （P 　　[Key words] Laparoscopic； Branch renal artery； Renal tumor； Open oper