后腹腔镜下肾部分切除术对肾癌患者肾功能和预后的影响

目的:探讨后腹腔镜下肾部分切除术对肾癌患者肾功能以及近远期预后的影响。方法:回顾性分析2012年1月～2017年8月在我院接受手术治疗的肾癌患者92例,根据不同手术治疗方法分为观察组(n=48)和对照组(n=44)。对照组行传统开放手术治疗,观察组行后腹腔镜下肾部分切除术。对比两组患者术前、术后血清肌酐(Cr)、血尿素氮(BUN)、β2-微球蛋白(β2-MG)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平的变化,术后1年、3年、5年生存率及切口感染、肺部感染、腹部疼痛、肾周血肿等并发症的发生情况。结果:观组患者手术时间、术后胃肠功能恢复时间、住院时间均明显短于对照组(P0.05),术中出血量、术后引流管引流量均显著低于对照组(P0.05)。术后1个月、术后2个月,两组患者血清Cr、BUN、β2-MG表达水平均较治疗前上升,且观察组以上指标显著低于对照组(P0.05)。术后,两组患者血清CRP、IL-6水平虽有升高,但观察组以上指标明显低于对照组(P0.05)。两组患者术后3年、5年的生存率均较术前下降,但观察组均分别高于对照组(P0.05)。术后,两组患者均有出现切口感染、肺部感染、腹部疼痛、肾周血肿等并发症,观察组总发生率(10.42%)明显低于对照组(29.54%,P0.05)。结论:后腹腔镜下肾部分切除术治疗肾癌患者可缩短患者的住院时间,对肾功能影响小,明显提高患者术后3年、5年生存率,且安全性更高。

Effect of Retroperitoneal Laparoscopic Partial Nephrectomy on Renal Function and Prognosis in Patients with Renal Cancer Cell Carcinoma

ABSTRACT Objective: To investigate the effect of retroperitoneal laparoscopic partial nephrectomy on renal function and long-term prognosis in patients with renal cancer. Methods: A retrospective analysis was made on 92 patients with renal cancer who underwent surgery in our hospital from January 2012 to August 2017. According to different surgical methods, the patients were divided into observation group(n=48) and control group (n=44). The control group received traditional open surgery, while the observation group received retroperitoneal laparoscopic partial nephrectomy. The changes of serum creatinine (Cr), blood urea nitrogen (BUN), beta-2-mi- croglobulin (beta-2-MG), C-reactive protein (CRP), interleukin-6 (IL-6) levels before and after operation, the 1-year, 3-year and 5-year survival rates, incision infection, pulmonary infection, abdominal pain, perirenal hematoma and other complications were compared be- tween the two groups. Results: The operation time, recovery time of gastrointestinal function and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05). The amount of bleeding during operation and the drainage vol- ume after operation were significantly lower than those in the control group(P<0.05). One month after operation and two months after op- eration, the levels of serum Cr, BUN and beta 2-MG in the two groups were higher than those before treatment, and the above indexes in the observation group were significantly lower than those in the control group(P<0.05). After operation, the serum CRP and IL-6 levels in the two groups increased, but the above indexes in the observation group were significantly lower than those in the control group (P< 0.05). The 3-year and 5-year survival rates of the two groups were lower than those of the control group, but the survival rates of the observation group were higher than those of the control group (P<0.05). After operation, incision infection, pulmonary infection, abdominal pain, perirenal hematoma and other complications occurred in both groups. The total incidence of the observation group (10.42%) was signifi- cantly lower than that of the control group (29.54%, P<0.05). Conclusion: Retroperitoneal laparoscopic partial nephrectomy can shorten the hospitalization time of patients with renal cancer, has little effect on renal function, and significantly improves the 3-year and 5-year survival rate of patients with renal cancer, and has higher safety.