[1]王浩飞 徐兆平 黄欣 张翀宇 芮文斌 孙福康 祝宇 沈周俊.经腹膜后和经腹腹腔镜下肾根治性切除术的比较[J].中华腔镜泌尿外科杂志(电子版),2015,(04):243-246.[doi:10.3877/cma.j.issn.1674-3253.2015.04.002 ]
　Wang Haofei,Xu zhaoping,Huang Xin,et al.Comparison of transperitoneal and retroperitoneal laparoscopic radical nephrectomy[J].,2015,(04):243-246.[doi:10.3877/cma.j.issn.1674-3253.2015.04.002 ]
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经腹膜后和经腹腹腔镜下肾根治性切除术的比较()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2015年04期
页码:
243-246
栏目:
临床研究
出版日期:
2015-12-30

文章信息/Info

Title:
Comparison of transperitoneal and retroperitoneal laparoscopic radical nephrectomy
作者:
王浩飞 徐兆平 黄欣 张翀宇 芮文斌 孙福康 祝宇 沈周俊
200025 上海，交通大学附属瑞金医院泌尿外科
Author(s):
Wang Haofei;  Xu zhaoping;  Huang Xin;  Zhang CongYu;  Rui Wenbin;  Sun Fukang;  Zhu Yu;  Shen Zhoujun.
Department of Urology, Ruijin Hospital, Jiaotong University, Shanghai 200025, China
关键词:
肾肿瘤; 腹腔镜; 手术
DOI:
10.3877/cma.j.issn.1674-3253.2015.04.002
摘要:
目的比较经腹膜后和经腹腹腔镜下肾根治性切除术的疗效。方法对 2010年 1月到 2013年 12月期间上海交通大学附属瑞金医院 152例腹腔镜下肾根治性切除术患者进行回顾性分析，其中经腹腔路径组 78例，经后腹腔路径组 74例，比较这两种手术路径在肿瘤大小、手术时间、出血量、术后肠道恢复时间、术后住院时间、并发症以及预后等方面的差异。结果所有手术均在腹腔镜下完成，没有中转开放。经腹路径组的手术时间、术中出血量、术后肠道恢复时间、术后住院时间和肿瘤大小分别为（ 138.0±31.8）min、（118.0±72.6）ml、（1.8±1.3）d、（5.8±2.3）d、（6.8±3.2）cm，经腹膜后路径组分别为（ 121.2±20.4）min、（109.4±67.2）ml、（1.7±1.5）d、（5.4±2.7）d、（5.3±2.1）cm。经腹路径的手术时间、肿瘤大小和经腹膜后路径相比有明显差异（ P<0.05）。两组在术中出血量、术后肠道恢复时间和术后住院时间方面无明显差异（ P>0.05）。结论对于根治性肾切除，无论是采用经腹还是经腹膜后路径均能取得良好的手术效果。对于体积较大的肿瘤，经腹路径可能更适合。

参考文献/References:

[1] Clayman RV, Kav0ussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report[J]. J Urol, 1991, 146(2): 278-282. [2] 方东, 李学松. 腹腔镜上尿路手术经腹腔路径更有优势[J]. 现代泌尿外科杂志, 2013, 18(2): 183-184. [3] 谭书韬, 张骞. 腹腔镜上尿路手术经腹膜后入路更有优势[J]. 现代泌尿外科杂志, 2013, 18(2): 185-187. [4] 蔡林, 周利群. 腹腔镜上尿路手术入路选择: 经腹腔还是腹膜后[J] ? 现代泌尿外科杂志, 2013, 18(2): 187, 194. [5] Gaur DD. Laparoscopic operative retroperitoneoscopy: use of new device[J]. J Urol, 1992, 148(4): 1137-1139. [6] Sanaa A. El-tohamy, Haitham M. Shello. Retroperitoneal versus transperitoneal laparoscopy for simple nephrectomy [J]. Egyptian Journal of Anaesthesia, 2013, 29(2): 109-116. [7] Shoma AM, El Nahas AR, Bazeed MA. Laparoscopic pyeloplasty: a prospective randomized comparison between the transperitoneal approach and retroperitoneoscopy [J]. J Urol, 2007, 178 (5): 2020-2024; discussion 2024. [8] Abuanz S, Game X, Roche JB, et al. Laparoscopic pyeloplasty: comparison between retroperitoneoscopic and transperitoneal approach[J]. Urology, 2010, 76(4): 877-881. [9] Nambirajan T, Jeschke S, Al-Zahrani H, et al. Prospective, randomized controlled study: transperitoneal laparoscopic versus retroperitoneoscopic radical nephrectomy. [J]. Urology, 2004, 64 (5): 919-924. [10] Nadler RB, Loeb S, Clemens JQ, et al. A prospective study of laparoscopic radical nephrectomy for T1 tumors - Is transperitoneal, retroperitoneal or hand assisted the best approach [J]. J Urol, 2006, 175(4): 1230-1233. [11] Garg M, Singh V, Sinha RJ, et al. Prospective randomized comparison of transperitoneal vs retroperitoneal laparoscopic simple nephrectomy[J]. Urology, 2014, 84(2): 335-339. [12] Zhu H, Shen C, Li X, et al. Laparoscopic pyeloplasty: a comparison between the transperitoneal and retroperitoneal approach during the learning curve. [J]. Urol Int. 2013;90 (2): 130-135. [13] Bayrak O, Seckiner I, Erturhan S, et al. Comparison of the complications and the cost of open and laparoscopic radical nephrectomy in renal tumors larger than 7 centimeters [J]. Urol J, 2014, 11(1): 1222-1227.

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备注/Memo

备注/Memo:
通讯作者：王浩飞，Email：wanglog@sina.com
更新日期/Last Update: 1900-01-01