后腹腔镜联合尿道等离子电切镜行肾盂癌根治术的疗效观察

发布时间：2019-05-11 18:51

【摘要】：目的探讨研究后腹腔镜联合经尿道等离子电切术行肾盂癌根治术治疗肾盂癌的临床疗效。方法回顾分析2008年6月至2012年6月间施行20例后腹腔镜联合尿道等离子电切镜行肾盂癌根治术（联合电切镜组）及32例腹腔镜肾盂癌根治术（腹腔镜组）。比较两组术中出血量、手术时间、术后肛门恢复通气时间、术后开始下床时间、术后住院时间等各项指标,并进行统计学分析。所有患者被随访17-48个月，并比较两组手术后的膀胱复发肿瘤情况。结果两组手术均顺利完成，无中转开放手术病例。无大出血、肠道损伤及漏尿等严重并发症。联合电切镜手术组的术中出血量、手术时间、术后肛门恢复通气时间、术后开始下床时间及术后住院时间分别为113.7±59.9ml、172.6±23.9分、26.4±12.4小时、28.1±12.6小时及6.70±0.8天；腹腔镜手术组分别为218.5±86.6ml、200.9±21.6分、40.6±15.7小时、46.8±12.5小时及9.1±1.2天。联合电切镜组在术中出血量、手术时间、术后肛门恢复通气时间、术后开始下床时间及术后住院时间均优于腹腔镜组（P0.05)。随访17-48个月，术后联合电切镜手术组与腹腔镜手术组膀胱内肿瘤复发率分别为5%和6.25%，两组膀胱复发率相比无统计学意义（P＞0.05）。结论后腹腔镜联合经尿道等离子电切术行肾盂癌根治术治疗肾盂癌，有效、安全，创伤小、不增加膀胱内复发风险，术后恢复快、并发症少，不增加膀胱内肿瘤复发率。
[Abstract]:Objective to investigate the clinical effect of retroperitoneal laparoscopy combined with transurethral plasma resection in the treatment of renal pelvis carcinoma. Methods from June 2008 to June 2012, 20 cases of retrolaparoscopic combined urethral plasma resection of renal pelvis carcinoma (combined resection group) and 32 cases of laparoscopic radical resection of renal pelvis carcinoma (laparoscopy group) were analyzed retrospectively. the results showed that 20 cases of renal pelvis carcinoma and 32 cases of laparoscopic radical resection of renal pelvis carcinoma (laparoscopy group) were performed from June 2008 to June 2012. The intraoperative bleeding volume, operation time, postoperative anal recovery ventilation time, postoperative departure time, postoperative hospitalization time and other indexes were compared between the two groups, and statistical analysis was carried out. All patients were followed up for 17 to 48 months and the recurrent bladder tumors were compared between the two groups. Results the operation was successfully completed in both groups, and there were no cases of conversion to open surgery. There were no serious complications such as massive bleeding, intestinal injury and urine leakage. The amount of intraoperative bleeding, operation time, postoperative anal recovery ventilation time, postoperative departure time and postoperative hospitalization time were 113.7 卤59.9 ml, 172.6 卤23.9 and 26.4 卤12.4 hours, respectively. 28.1 卤12.6 hours and 6.70 卤0.8 days; The laparoscopic operation group was 218.5 卤86.6 ml, 200.9 卤21.6 minutes, 40.6 卤15.7 hours, 46.8 卤12.5 hours and 9.1 卤1.2 days, respectively. The amount of bleeding during operation, the time of anal recovery ventilation, the time of getting out of bed and the time of hospitalization after operation in the combined resection group were better than those in the laparoscopy group (P 0.05). The recurrence rates of intravesical tumors in the combined resection group and laparoscopic surgery group were 5% and 6.25%, respectively. there was no significant difference between the two groups (P > 0.05). Conclusion radical resection of renal pelvis carcinoma by retrolaparoscopy combined with transurethral plasma resection is effective, safe, less traumatic, does not increase the risk of intravesical recurrence, recovers quickly after operation, has fewer complications, and does not increase the recurrence rate of intravesical tumor.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11

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