【摘要】：目的探討研究后腹腔鏡聯(lián)合經(jīng)尿道等離子電切術(shù)行腎盂癌根治術(shù)治療腎盂癌的臨床療效。 方法回顧分析2008年6月至2012年6月間施行20例后腹腔鏡聯(lián)合尿道等離子電切鏡行腎盂癌根治術(shù)（聯(lián)合電切鏡組）及32例腹腔鏡腎盂癌根治術(shù)（腹腔鏡組）。比較兩組術(shù)中出血量、手術(shù)時(shí)間、術(shù)后肛門恢復(fù)通氣時(shí)間、術(shù)后開(kāi)始下床時(shí)間、術(shù)后住院時(shí)間等各項(xiàng)指標(biāo),并進(jìn)行統(tǒng)計(jì)學(xué)分析。所有患者被隨訪17-48個(gè)月，并比較兩組手術(shù)后的膀胱復(fù)發(fā)腫瘤情況。 結(jié)果兩組手術(shù)均順利完成，無(wú)中轉(zhuǎn)開(kāi)放手術(shù)病例。無(wú)大出血、腸道損傷及漏尿等嚴(yán)重并發(fā)癥。聯(lián)合電切鏡手術(shù)組的術(shù)中出血量、手術(shù)時(shí)間、術(shù)后肛門恢復(fù)通氣時(shí)間、術(shù)后開(kāi)始下床時(shí)間及術(shù)后住院時(shí)間分別為113.7±59.9ml、172.6±23.9分、26.4±12.4小時(shí)、28.1±12.6小時(shí)及6.70±0.8天；腹腔鏡手術(shù)組分別為218.5±86.6ml、200.9±21.6分、40.6±15.7小時(shí)、46.8±12.5小時(shí)及9.1±1.2天。聯(lián)合電切鏡組在術(shù)中出血量、手術(shù)時(shí)間、術(shù)后肛門恢復(fù)通氣時(shí)間、術(shù)后開(kāi)始下床時(shí)間及術(shù)后住院時(shí)間均優(yōu)于腹腔鏡組（P0.05)。隨訪17-48個(gè)月，術(shù)后聯(lián)合電切鏡手術(shù)組與腹腔鏡手術(shù)組膀胱內(nèi)腫瘤復(fù)發(fā)率分別為5%和6.25%，兩組膀胱復(fù)發(fā)率相比無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。 結(jié)論后腹腔鏡聯(lián)合經(jīng)尿道等離子電切術(shù)行腎盂癌根治術(shù)治療腎盂癌，有效、安全，創(chuàng)傷小、不增加膀胱內(nèi)復(fù)發(fā)風(fēng)險(xiǎn)，術(shù)后恢復(fù)快、并發(fā)癥少，不增加膀胱內(nèi)腫瘤復(fù)發(fā)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 鹵59.9 ml, 172.6 鹵23.9 and 26.4 鹵12.4 hours, respectively. 28.1 鹵12.6 hours and 6.70 鹵0.8 days; The laparoscopic operation group was 218.5 鹵86.6 ml, 200.9 鹵21.6 minutes, 40.6 鹵15.7 hours, 46.8 鹵12.5 hours and 9.1 鹵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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.11

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