腹腔镜下保留肾单位手术及肾癌根治术治疗T1期肾癌的疗效比较
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【关键词】腹腔镜保留肾单位手术肾癌根治术T1期肾癌
【中图分类号】R737.11【文献标识码】A【文章编号】2095-1752（2014）25-0019-02
The clinical comparison of curing clinical T1 renal carcinoma by laparoscopic partial nephrectomy and radical nephrectomy
对象与方法
一一般资料
本组57例，男39例，女18例，年龄41－87岁，平均64岁，所有患者均无明显临床症状和体征，肿瘤均于体检时彩超或CT发现，肿瘤平均直径3.5cm。肾上极肿瘤29例，肾中极6例，肾下极22例。彩超、CT检查均提示肾实质性占位性病变，无淋巴结、肾血管或腔静脉受累。患者临床分期均为T1期。57例患者中行腹腔镜保留肾单位手术36例，腹腔镜肾癌根治术21例。LPN手术组:男26例,女10例；22例经CT检查发现，14例为彩超发现；肾上极肿瘤18例，肾中极2例，肾下极16例。腹腔镜肾癌根治术组：男13例,女8例；14例经CT检查发现，7例为彩超发现；肾上极肿瘤11例，肾中极4例，肾下极6例。手术切除标本均行病理检查，57例肿瘤患者病理组织分型：透明细胞癌40例，乳头状细胞癌9例，嫌色细胞癌3例，囊腺癌4例，肾母细胞瘤1例。
【Key words】Laparoscopy; partial nephrectomy; radical nephrectomy; clinical T1 renal carcinoma
随着腹腔镜技术经验的积累和疗T1期肾癌的重要手术方式。我院2009年至2014年收治T1期肾癌患者57例，其中实施腹腔镜保留肾单位手术36例，腹腔镜肾癌根治术21例。现将其临床资料分析报告如下：
【Abstract】Objective To approach clinical curative effect of curing clinical T1 renal carcinoma by the laparoscopic partial nephrectomy and radical nephrectomy. Methods The data of 57 patients with clinical T1 renal carcinoma were reviewed,36 cases with laparoscopic partial nephrectomy and 21cases with laparoscopic radical nephrectomy during a 8-year frame. Parameters associated with the surgical procedures (amount of bleeding during operation, operation time), the hospital stay postoperative and the rate of early complications (less than 3 months after surgery) were compared between the two groups. Results There were significant difference in hospital stay postoperative, volume of blood loss during operation, urinary fistula, renal failure after surgery, mortality after operation and postoperative urinary infection between the two groups(P<0.05). Conclusions the laparoscopic partial nephrectomy and radical nephrectomy are both good forms of clinical T1 renal carcinoma. We failed to find enough evidence that peritoneal laparoscopic partial nephrectomy is better than radical nephrectomy.
腹腔镜下保留肾单位手术及肾癌根治术治疗T1期肾癌的疗效比较
摘要】目的探讨T1期肾癌腹腔镜下行两种不同术式的临床效果。方法回顾分析57例T1期肾癌患者，其中行腹腔镜保留肾单位手术（laparoscopic partial nephrectomy，LPN）36例，腹腔镜肾癌根治性术（laparoscopic radical nephrectomy,）21例，对两组患者在出血量、手术时间、术后平均住院天数以及术后并发症等方面进行统计学比较分析。结果腹腔镜保留肾单位手术组在术后平均住院天数及术后漏尿发生率等方面高于腹腔镜肾癌根治术组，两者差异具有统计学意义（P<0.05）。而在手术时间、术中出血量、术后肾功能衰竭、围手术期死亡、术后泌尿系感染发生率及术中胸膜、肝、脾等脏器损伤的发生率等均低于腹腔镜肾癌根治术组，差异有统计学意义（P<0.05）。结论腹腔镜下保留肾单位手术与肾癌根治术在治疗T1期肾癌中各有优缺点，都是目前较好的治疗T1期肾癌的手术方式，值得临床上推广应用。
Chen Qing, Zhang Wen-bin, Wu BO-cong, Huang Zhi-yang, Cai Jing-shuang(Department of Urology，the Quanzhou first Hospital Affiliated Fujian Medical University，Quanzhou 362000，China)
【中图分类号】R737.11【文献标识码】A【文章编号】2095-1752（2014）25-0019-02
The clinical comparison of curing clinical T1 renal carcinoma by laparoscopic partial nephrectomy and radical nephrectomy
对象与方法
一一般资料
本组57例，男39例，女18例，年龄41－87岁，平均64岁，所有患者均无明显临床症状和体征，肿瘤均于体检时彩超或CT发现，肿瘤平均直径3.5cm。肾上极肿瘤29例，肾中极6例，肾下极22例。彩超、CT检查均提示肾实质性占位性病变，无淋巴结、肾血管或腔静脉受累。患者临床分期均为T1期。57例患者中行腹腔镜保留肾单位手术36例，腹腔镜肾癌根治术21例。LPN手术组:男26例,女10例；22例经CT检查发现，14例为彩超发现；肾上极肿瘤18例，肾中极2例，肾下极16例。腹腔镜肾癌根治术组：男13例,女8例；14例经CT检查发现，7例为彩超发现；肾上极肿瘤11例，肾中极4例，肾下极6例。手术切除标本均行病理检查，57例肿瘤患者病理组织分型：透明细胞癌40例，乳头状细胞癌9例，嫌色细胞癌3例，囊腺癌4例，肾母细胞瘤1例。
【Key words】Laparoscopy; partial nephrectomy; radical nephrectomy; clinical T1 renal carcinoma
随着腹腔镜技术经验的积累和疗T1期肾癌的重要手术方式。我院2009年至2014年收治T1期肾癌患者57例，其中实施腹腔镜保留肾单位手术36例，腹腔镜肾癌根治术21例。现将其临床资料分析报告如下：
【Abstract】Objective To approach clinical curative effect of curing clinical T1 renal carcinoma by the laparoscopic partial nephrectomy and radical nephrectomy. Methods The data of 57 patients with clinical T1 renal carcinoma were reviewed,36 cases with laparoscopic partial nephrectomy and 21cases with laparoscopic radical nephrectomy during a 8-year frame. Parameters associated with the surgical procedures (amount of bleeding during operation, operation time), the hospital stay postoperative and the rate of early complications (less than 3 months after surgery) were compared between the two groups. Results There were significant difference in hospital stay postoperative, volume of blood loss during operation, urinary fistula, renal failure after surgery, mortality after operation and postoperative urinary infection between the two groups(P<0.05). Conclusions the laparoscopic partial nephrectomy and radical nephrectomy are both good forms of clinical T1 renal carcinoma. We failed to find enough evidence that peritoneal laparoscopic partial nephrectomy is better than radical nephrectomy.
腹腔镜下保留肾单位手术及肾癌根治术治疗T1期肾癌的疗效比较
摘要】目的探讨T1期肾癌腹腔镜下行两种不同术式的临床效果。方法回顾分析57例T1期肾癌患者，其中行腹腔镜保留肾单位手术（laparoscopic partial nephrectomy，LPN）36例，腹腔镜肾癌根治性术（laparoscopic radical nephrectomy,）21例，对两组患者在出血量、手术时间、术后平均住院天数以及术后并发症等方面进行统计学比较分析。结果腹腔镜保留肾单位手术组在术后平均住院天数及术后漏尿发生率等方面高于腹腔镜肾癌根治术组，两者差异具有统计学意义（P<0.05）。而在手术时间、术中出血量、术后肾功能衰竭、围手术期死亡、术后泌尿系感染发生率及术中胸膜、肝、脾等脏器损伤的发生率等均低于腹腔镜肾癌根治术组，差异有统计学意义（P<0.05）。结论腹腔镜下保留肾单位手术与肾癌根治术在治疗T1期肾癌中各有优缺点，都是目前较好的治疗T1期肾癌的手术方式，值得临床上推广应用。
Chen Qing, Zhang Wen-bin, Wu BO-cong, Huang Zhi-yang, Cai Jing-shuang(Department of Urology，the Quanzhou first Hospital Affiliated Fujian Medical University，Quanzhou 362000，China)