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目的探讨后腹腔镜下肾部分切除术治疗肾肿瘤的临床疗效。方法 25例行后腹腔镜下肾部分切除术的肾肿瘤患者作为实验组。25例行开放性肾部分切除术的患者作为对照组。对比两组患者的手术效果、时间、术中出血量及并发症的发生率。结果实验组顺利实施腹腔镜手术24例,实施开放性手术1例。手术时间(109±30.4)min,术中出血量(104±32.7)ml,平均肾动脉阻断时间(31.8±6.7)min;对照组患者手术时间(192±41.3)min,术中出血量(257±46.5)ml,平均肾动脉阻断时间(37.4±6.5)min,实验组明显优于对照组,差异均具有统计学意义(P<0.05)。实验组患者术后出现1例结肠损伤、1例血肿,对照组患者术后出现2例结肠损伤、3例血肿,实验组明显低于对照组,差异具有统计学意义(P<0.05)。结论后腹腔镜下肾部分切除术相比传统的开放性手术具有明显优势,其手术创伤小,患者术中出血量少,术后恢复时间短,安全可靠,值得临床广泛推广。
Objective To investigate the clinical effect of retroperitoneoscopic partial nephrectomy in the treatment of renal tumors. Methods Twenty-five patients underwent laparoscopic partial nephrectomy for kidney cancer as experimental group. Twenty-five patients undergoing open partial nephrectomy served as control group. The operative effect, time, intraoperative blood loss and complication rates were compared between the two groups. Results The experimental group successfully implemented laparoscopic surgery in 24 cases, the implementation of open surgery in 1 case. The operation time (109 ± 30.4) min, intraoperative blood loss (104 ± 32.7) ml and mean renal artery occlusion time were (31.8 ± 6.7) min. The operation time of the control group (192 ± 41.3) min, intraoperative blood loss 257 ± 46.5) ml, mean renal artery occlusion time (37.4 ± 6.5) min, the experimental group was significantly better than the control group, the difference was statistically significant (P <0.05). One case of colonic injury and one case of hematoma occurred in the experimental group. Two cases of colon injury and three cases of hematoma occurred in the control group. The experimental group was significantly lower than the control group (P <0.05). Conclusions Retroperitoneal laparoscopic partial nephrectomy has obvious advantages over traditional open surgery. It has less trauma, less intraoperative blood loss, shorter postoperative recovery time, and is safe and reliable. It is worth widely clinical application.