目的:分析侧腹入路和后腹腔入路LPN治疗早期肾癌的安全性和可行性。方法:选取2014年3月~2016年4月收治的收治的侧腹入路和后腹腔入路行LPN的$T_{1_{a}}$N₀M₀期肾癌患者97例,其中侧腹入路LPN组46例,后腹腔入路LPN组51例。比较两组的手术时间、术中出血量、肿瘤重量、住院时间、术后GFR、转开放手术和并发症。结果:两组切除的肿瘤重量、术后GFR和转开放手术的例数等比较差异无统计学意义( P>0.05)。侧腹入路LPN组手术时间、术中出血量、住院时间分别为(132.36±25.74)min、(192.95±42.61)ml和(8.34±1.52)d,均显著低于后腹腔入路LPN组的(161.52±31.73)min、(232.16±48.27)ml和(9.87±1.87)d( P<0.05)。侧腹入路LPN组术中并发症发生率为2.2%,术后并发症发生率为4.3%,均显著低于后腹腔入路LPN组的7.8%和9.8%( P<0.05)。结论:侧腹入路LPN治疗早期肾癌,有利于患者术后恢复,并发症少,可以作为一种新的LPN入路方式推广使用。

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 (all P<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.