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目的通过与标准经腹腹腔镜肾癌根治术进行对照研究,评价经脐单孔多通道腹腔镜肾癌根治术的临床疗效。方法 2008年9月至2011年1月,本单位同一手术组共完成经腹腹腔镜肾癌根治术105例,其中经脐单孔腹腔镜肾癌根治术21例,标准经腹腹腔镜肾癌根治术84例。回顾性分析和比较21例单孔腹腔镜肾癌根治术(A组,2009年9月至2011年1月)和21例标准经腹腹腔镜肾癌根治术(B组,2008年9月至2010年3月)的临床资料和随访信息。两组的配比因素为:患者年龄、体质指数、肿瘤最大径及位置、手术适应证(T1期)。结果 A、B两组的术后疼痛评分分别为3.5±0.84和4.1±1.06,术后肠道功能恢复时间分别为(31.6±17.98)、(42.3±19.94)h,手术切口满意度评分分别为8.2±0.71和7.3±0.85,差异均有统计学意义(P<0.05)。两组的前10例手术时间差异有统计学意义(P=0.030),但后10例(P=0.495)及总体(P=0.076)手术时间差异均无统计学意义。术后随访时间分别为(8.4±4.41)和(20.0±3.95)个月(P=0.000),两组患者均未出现肿瘤复发或转移。结论与标准经腹腹腔镜肾癌根治术相比,经脐单孔多通道腹腔镜手术患者术后疼痛轻,肠道功能恢复快,切口满意度高,但肿瘤治疗效果仍需进一步长期随访予以证实。
Objective To evaluate the clinical efficacy of trans-laparoscopic radical nephrectomy with standard laparoscopic radical nephrectomy. Methods From September 2008 to January 2011, 105 patients undergoing laparoscopic radical nephrectomy were performed in the same operation group, including 21 cases undergoing single-hole laparoscopic radical nephrectomy, Radical surgery in 84 cases. 21 cases of single-hole laparoscopic radical nephrectomy (group A, September 2009 to January 2011) and 21 cases of standard laparoscopic radical nephrectomy (group B, September 2008 to March 2008) were retrospectively analyzed and compared March 2010) of the clinical data and follow-up information. The two groups of matching factors are: patient age, body mass index, tumor diameter and location, surgical indication (T1). Results The postoperative pain scores of A and B groups were 3.5 ± 0.84 and 4.1 ± 1.06, respectively. The recovery time of intestinal function after operation was (31.6 ± 17.98) and (42.3 ± 19.94) h, respectively. The satisfaction scores of surgical incision were 8.2 ± 0.71 and 7.3 ± 0.85 respectively, the difference was statistically significant (P <0.05). There was no significant difference in operation time between the two groups (P = 0.030), but there was no significant difference in the last 10 cases (P = 0.495) and overall operation time (P = 0.076). The follow-up time was (8.4 ± 4.41) and (20.0 ± 3.95) months (P = 0.000), respectively. No recurrence or metastasis was found in both groups. Conclusions Compared with standard laparoscopic radical nephrectomy, postoperative umbilical single hole multi-channel laparoscopic surgery has the advantages of less postoperative pain, faster recovery of intestinal function and better incision satisfaction, but the effect of tumor treatment still needs further long-term follow-up Confirmed.