Abstract：Objective: To analyze the clinical efficacy and safety of lateral transperitoneal and retroperitoneal laparoscopic partial nephrectomy (LPN). Methods: Ninety-six cases of $T_{1_{a}}$N0M0 renal tumors undergoing lateral transperitoneal and retroperitoneal LPN were selected in this study. The patients were divided into lateral transperitoneal LPN group (n=46) and retroperitoneal LPN group (n=51). The operation time, blood loss volume, tumor weight, hospital stay, postoperative GFR, rate of conversion to open surgery, and complications were compared between the two groups. Results: There was no significant difference in tumor weight, postoperative GFR, and rate of conversion to open surgery between the two groups (P>0.05). The operation time, blood loss volume, and hospital stay was (132.36±25.74) min, (192.95±42.61) mL, and (8.34±1.52) days in lateral transperitoneal LPN group, which were significantly reduced as compared with those of (161.52±31.73) min, (232.16±48.27) mL, and (9.87±1.87) days in retroperitoneal LPN group (allP<0.05). The incidence of intraoperative and postoperative complications was 2.2% and 4.3% in lateral transperitoneal LPN group, which was significantly lower than that of 7.8% and 9.8% in retroperitoneal LPN group (P<0.05). Conclusions: Lateral transperitoneal LPN was beneficial to postoperative recovery in treatment of early renal cell carcinoma patients, with less complications. It can be used as a new way to improve LPN approach.
刘佳勋, 夏建宇, 於建鹏. 侧腹入路和后腹腔入路腹腔镜下肾部分切除术治疗早期肾癌的安全性和可行性分析[J]. 微创泌尿外科杂志, 2018, 7(1): 11-13.
Liu Jiaxun, Xia Jianyu, Yu Jianpeng. The clinical efficacy and safety of lateral transperitoneal and retroperitoneal laparoscopic partial nephrectomy for early renal cell carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(1): 11-13.
[1] Dong W, Lin T, Li F, et al.Laparoscopic Partial Nephrectomy for T1 Renal Cell Carcinoma: Comparison of Two Resection Techniques in a Multi-institutional Propensity Score-Matching Analysis. Ann Surg Oncol, 2016,23(4):1395-1402. [2] Fu J, Ye S, Ye HJ.Retroperitoneal Versus Transperitoneal Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-analysis. Chin Med Sci J, 2015,30(4):239-244. [3] 邱志磊,张欣红,梁鑫,等.侧腹入路行腹腔镜肾部分切除术的临床疗效分析.临床泌尿外科杂志,2015,30(8):675-678. [4] 王玉杰,安恒庆.肾肿瘤的微创治疗新进展.新疆医学,2016,46(4):375,380-381. [5] 陈南辉,陈智林,黄志成,等.腹膜后入路腹腔镜肾段动脉阻断肾部分切除术治疗早期肾癌(附39例报道).岭南现代临床外科,2014,14(5):583-586. [6] 周青英,黄达飞,郑定钦.经腹入路与后腹腔入路腹腔镜超声辅助的肾部分切除术治疗中央型肾癌的临床比较.腹腔镜外科杂志,2016,21(3):215-219. [7] Yu W, Zhou G, Cheng F, et al.Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy. Indian J Surg, 2015,77(Suppl 3):1343-1347. [8] Chai YJ, Woo JW, Kwon H, et al.Comparative outcomes of lateral transperitoneal adrenalectomy versus posterior retroperitoneoscopic adrenalectomy in consecutive patients: A single surgeon's experience. Asian J Surg, 2016,39(2):74-80. [9] Pedziwiatr M, Matlk M, Kulawik J, et al.Laparoscopic adrenalectomy by the lateral transperitoneal approach in patients with a history of previous abdominal surgery. Wideochir Inne Tech Maloinwazyjne, 2013,8(2):146-151. [10] 肖卫忠,陈勇,潘森,等.经腹膜与腹膜后腹腔镜下肾部分切除术疗效和安全性比较的Meta分析.中华临床医师杂志(电子版),2016,10(8):94-100.
