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全后腹腔3D腹腔镜与2D腹腔镜治疗上尿路上皮癌疗效对比

Clinical efficacy of total retroperitoneal 3D vs. 2D laparoscopy in treating upper urothelial carcinoma
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摘要 目的:对比全后腹腔3D腹腔镜与2D腹腔镜治疗上尿路上皮癌的临床疗效。方法:2010年3月-2018年3月收治上尿路上皮癌患者67例,分别行全腹膜后3D腹腔镜切除患肾及输尿管并做膀胱袖套状切除(3D组,21例)及腹膜后腹腔镜患肾、输尿管及部分膀胱切除(2D组,46例)。分析并比较两组患者的围手术期情况。结果:67例手术均获得成功。3D腹腔镜组手术时间(2.19±0.03)h,术中出血量(38.33±1.81)mL,术后留置引流管引流量(26.05±1.85)mL/d,术后住院时间(6.71±0.16)d;2D腹腔镜组手术时间(2.56±0.01)h,术中出血量(51.48±1.61)mL,术后留置引流管引流量(30.46±1.55)mL/d,术后住院时间(6.87±0.13)d。两组手术时间及出血量比较差异有统计学意义(P<0.05)。对所有患者随访8~48个月,平均30个月,未出现复发。结论:全腹膜后3D腹腔镜肾输尿管切除术治疗肾盂、输尿管癌,可取得满意的效果,手术创伤小,恢复快,值得临床推广。 Objective:To compare the clinical efficacy of total posterior abdominal 3 D laparoscope and 2 D laparoscope in the treatment of upper urothelial carcinoma.Methods:From March 2010 to March 2018,67 patients with upper urothelial carcinoma were treated with the following methods in our hospital:(1)total retroperitoneal 3 D laparoscopic resection of kidney and ureter and bladder sleeve resection;(2)retroperitoneal resection of the affected kidney and ureter and small incision of the lower abdomen were performed to remove the affected kidney,ureter and part of the bladder.The patients were divided into 3 D group and 2 D group according to the surgical methods,including 21 cases in3 D group and 46 cases in 2 D group.Perioperative conditions were analyzed and compared between the two groups.Results:All 67 procedures were successful.In 3 D laparoscope group,the surgical duration was(2.19±0.03)h,intra-operative hemorrhagic volume was(38.33±1.81)mL,postoperative drainage volume of indwelling drainage tube was(26.05±1.85)mL/day,and postoperative hospital stay was(6.71±0.16)days;In 2 D laparoscope group,the surgical duration was(2.56±0.01)h,intra-operative hemorrhagic volume was(51.48±1.61)mL,postoperative drainage volume of indwelling drainage tube was(30.46±1.55)mL/day,and postoperative hospital stay was(6.87±0.13)days.The difference in operation time and hemorrhagic volume between the two groups had statistical significance(P<0.05).All patients were followed up for 8-48 months,with an average of 30 months.No recurrence occurred.Conclusion:Total retroperitoneal 3 D laparoscopic nephroureterectomy for renal pelvis and ureter cancer can achieve satisfactory results,with small surgical trauma and fast recovery,which is worthy of clinical promotion.
作者 付钰 杨国胜 邱晓拂 钟瑞伦 刘百川 王炳卫 李高远 张涛 陈波特 刘跃加 FU Yu;YANG Guosheng;QIU Xiaofu;ZHONG Ruilun;LIU Baichuan;WANG Bingwei;LI Gaoyuan;ZHANG Tao;CHEN Bote;LIU Yuejia(Department of Urology,Guangdong Second Provincial General Hosptial,Guangzhou 510317,China)
出处 《微创泌尿外科杂志》 2019年第3期159-162,共4页
基金 广东省自然科学基金项目(2018A030313905).
关键词 肾盂癌 输尿管癌 3D腹腔镜 2D腹腔镜 renal pelvis cancer ureteral cancer 3D laparoscopic 2D laparoscopic
作者简介 通信作者:杨国胜,2008yangguoshe?ng@sina.com
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