Abstract：Objective: To investigate the clinical efficacy of different incision choice after laparoscopic radical nephrectomy. Methods: Totally 47 cases after laparoscopic radical nephrectomy during January 2011 to February 2016 in our hospital and during February 2016 to August 2016 in Chinese PLA General Hospital were retrospectively analyzed. The three groups were made according to the choice of different incisions： the oblique incision under costal margin as control group, the longitudinal incision by the rectus as observation group A, and the longitudinal incision under the umbilicus as observation group B. The incision length, the time specimen extraction, the degree of wound healing, the healing time, the regional complication and the recovery of touch sense in three groups were analyzed. Results: The average length of wound was （5.0 ± 1.5） cm, （4.0 ± 1.2） cm and （6.0 ± 2.0） cm in group A, group B and control group respectively. The average wound length was significantly shorter in the observation group B than in the control group （P < 0.05）. The time of specimen extraction in observation group A and B was （21.0 ± 4.0） min and （16.0 ± 3.6） min respectively, which was significantly shorter than that in control group （[24.0 ± 5.0] min, P < 0.05）. The wound healing rate in observation group A, observation group B and control group was 95%, 94.4% and 100%, respectively, with no significant difference among three groups （P > 0.05）. The wound healing time in observation group B （7.0 ± 1.2 d） was significantly shorter than in the control group （10.0 ± 2.0 d） （P < 0.05）. The incidence of wound complications was 10.0%, 5.6% and 11.1% in observation group A, observation group B and control group respectively, with no significant difference among groups （P > 0.05）. The time of touch recovery in observation group B （4.0 ± 1.6 month） was obviously shorter than that in control group （7.0 ± 2.6 month）. Conclusion: Different incision has influence on the recovery of patients after laparoscopic radical nephrectomy. The longitudinal incision under the umbilicus can achieve satisfactory efficacy, and is recommended in the clinical applications.
谢蛟魁, 雷霆, 王春扬, 孙圣坤, 李宏召, 符伟军. 腹腔镜下根治性肾切除术不同手术切口取标本的临床效果分析[J]. 微创泌尿外科杂志, 2021, 10(1): 12-15.
XIE Jiaokui, LEN Ting, WANG Chunyang, SUI Shengkui, LI Hongzhao, FU Weijun. Comparative study of different incision choice after laparoscopic radical nephrectomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(1): 12-15.
[1] COLLIN Y, MÉZIAT-BURDIN A, SABBAGH R. Transperitoneal laparoscopic radical nephrectomy after multiple previous abdominal surgeries and intraperitoneal hyperthermic chemotherapy: a case report. Can J Urol, 2012,19(2):6204-6206.
[2] 马鑫,李宏召,王超,等.后腹腔镜下肾筋膜应用解剖分型.临床泌尿外科志,2009,24(5):330-334.
[3] 梅勇. 小儿腹股沟斜疝横切口微创手术方式的临床应用.当代医学,2011,17(12):17-17,20.
[4] 张旭,叶章群,陈忠,等.腹腔镜肾切除17例报告.临床泌尿外科杂志,2000,15(11):501-502.
[5] 巫水周,袁国伟,朱才雄,等.传统疝囊高位结扎术和经腹小切口手术治疗小儿腹股沟斜疝的疗效比较.中国医药科学,2013,3(2):186-187.
[6] GODLEY PA, STINCHCOMBE TE.Renal cell carcinoma. Curr Opin Oncol, 1999,11:213-217.
[7] MCDOUGALL E, CLAYMAN RV, ELASHRY OM.Laparoscopic radical nephrectomy for renal tumor: the Washington University experience. J Urol, 1996,155(4):1180-1185.
[8] MATIN SF, GILL IS.Modified pfannenstiel incision for intact specimen extraction after retroperitoneoscopic renal surgery. Urology, 2003,61(4):830-832.
[9] ANDONIAN S, HERATI AS, ATALLA M, et al.Laparoendoscopic single-site pfannenstiel donor nephrectomy. Urology, 2010,75(1):9-12.
[10] SIMFOROOSH N, SARHANGNEJAD R, BASIRI A, et al.Vascular clips are safe and a great cost-effective technique for arterial and venous control in laparoscopic nephrectomy: single center experience with 1 834 laparoscopic nephrectomies. J Endourol, 2012,26(8):1009-1012.
[11] BIRD VG, AU JK, SANDMAN Y, et al.Comparison of different extraction sites used during laparoscopic radical nephrectomy. J Urol, 2009,181(4):1565-1570.
