Abstract:Objective: To compare the clinical efficacy of total posterior abdominal 3D laparoscope and 2D laparoscope in the treatment of upper urothelial carcinoma.Methods: From March 2010 to March 2018, 67 patients with upper urothelial carcinoma were treated with the following methods in our hospital: (1) total retroperitoneal 3D laparoscopic resection of kidney and ureter and bladder sleeve resection; (2) retroperitoneal resection of the affected kidney and ureter and small incision of the lower abdomen were performed to remove the affected kidney, ureter and part of the bladder. The patients were divided into 3D group and 2D group according to the surgical methods, including 21 cases in 3D group and 46 cases in 2D group. Perioperative conditions were analyzed and compared between the two groups. Results: All 67 procedures were successful. In 3D laparoscope group, the surgical duration was (2.19 ± 0.03) h, intra-operative hemorrhagic volume was (38.33±1.81) mL, postoperative drainage volume of indwelling drainage tube was (26.05 ± 1.85) mL/day, and postoperative hospital stay was (6.71 ± 0.16) days; In 2D laparoscope group, the surgical duration was (2.56±0.01) h, intra-operative hemorrhagic volume was (51.48 ± 1.61) mL, postoperative drainage volume of indwelling drainage tube was (30.46±1.55)mL/day, and postoperative hospital stay was (6.87±0.13) days. The difference in operation time and hemorrhagic volume between the two groups had statistical significance (P<0.05). All patients were followed up for 8-48 months, with an average of 30 months. No recurrence occurred. Conclusion: Total retroperitoneal 3D laparoscopic nephroureterectomy for renal pelvis and ureter cancer can achieve satisfactory results, with small surgical trauma and fast recovery, which is worthy of clinical promotion.
付钰, 杨国胜, 邱晓拂, 钟瑞伦, 刘百川, 王炳卫, 李高远, 张涛, 陈波特, 刘跃加. 全后腹腔3D腹腔镜与2D腹腔镜治疗上尿路上皮癌疗效对比[J]. 微创泌尿外科杂志, 2019, 8(3): 159-162.
FU Yu, YANG Guosheng, QIU Xiaofu, ZHONG Ruilun, LIU Baichuan, WANG Bingwei, LI Gaoyuan, ZHANG Tao, CHEN Bote, LIU Yuejia. Clinical efficacy of total retroperitoneal 3D vs. 2D laparoscopy in treating upper urothelial carcinoma. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(3): 159-162.
[1] 李博,顾恒,王昌兵,等.腹膜后腹腔镜肾盂癌、输尿管癌根治术13例报告.腹腔镜外科杂志,2012,17(12):943-944. [2] 石宁,王剑松,王海峰,等.经尿道输尿管软镜肾盂肿瘤铥激光切除术治疗肾盂肿瘤1例并文献复习.国际泌尿系统杂志,2018,38(2):272-274. [3] 郝一昌,陈昆,刘余庆,等.输尿管软镜下钬激光切除术治疗肾盂癌6例报道及文献复习.北京大学学报(医学版),2018,50(5):816-821. [4] MCNEILL SA, CHRISOFOS M, TOLLEY DA.The long-term outcome after laparoscopic nephroureterectomy:a comparison with open nephroureterectomy. BJU Int, 2000,86(6):619-623. [5] POTTER SR, CHOW GK, JARRETT TW.Percutaneous endoscopic management of urothelial tumors of the renal pelvis. Urology, 2001,58(3):457-459. [6] KATZ R, GOFRIT ON, GOLIJANIN D, et al.Urothelial cancer of the renal pelvis in percutaneous nephrolithotomy patients. Urol Int, 2005,75(1):17-20. [7] 汪群锋. 腹腔镜治疗肾盂癌的新进展.国际泌尿系统杂志,2014,34(4):615-619. [8] MANDALAPU RS, MATIN SF.Contemporary evaluation and management of upper tract urothelial cancer. Urology, 2016,94:17-23. [9] 周红庆,张小德,刘明生,等.3D腹腔镜系统在泌尿外科手术中的应用.临床医学研究与实践,2017,2(3):129. [10] 张治国,郝林,范涛,等.3D与2D腹腔镜肾上腺肿瘤切除术对比研究.现代泌尿生殖肿瘤杂志,2017,9(2):73-75. [11] 缪志俊,孙玉峰,李峰,等.传统2D腹腔镜与3D腹腔镜下前列腺癌根治手术疗效比较.现代泌尿生殖肿瘤杂志,2018,10(2):94-97. [12] 王卫平,吴震杰,徐红,等.机器人全腹膜外肾输尿管全长及膀胱袖状切除术的初步临床应用.中华泌尿外科杂志,2018,39(3):161-165. [13] 林榕城,周朝晖,钟文龙,等.完全腹膜后镜肾输尿管全长切除术治疗上尿路尿路上皮癌的临床分析.现代泌尿外科杂志,2018,23(10):748-751. [14] 韩家盛,房蕾,于海易,等.后腹腔镜下改良三通道肾输尿管全长膀胱袖状切除术治疗尿路上皮癌.实用医药杂志,2018,35(7):608-610. [15] LIU WT, WANG YH, ZHONG ZH, et al.Transperitoneal versus retroperitoneal laparoscopic nephroureterectomy in the management of upper urinary tract urothelial carcinoma: a matched-pair comparison based on perioperative outcomes. Surg Endosc, 2016,30(12):5537-5541. [16] FANG Z, LI L, WANG X, et al.Total retroperitoneal laparoscopic nephroureterectomy with bladder-cuff resection for upper urinary tract transitional cell carcinoma. J Invest Surg, 2014,27(6):354-359.