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目的:比较分析后腹腔镜下高选择性肾动脉阻断与肾动脉全阻断治疗T1a期肾透明细胞癌(<4cm)的临床疗效。方法:回顾性分析我院2011年1月~2013年10月55例T1a期肾透明细胞癌(<4cm)患者行后腹腔镜肾部分切除术(RLPN)的临床资料。根据术式分为高选择性肾动脉阻断组27例和肾动脉全阻断组患者28例,通过比较两组患者肾动脉阻断时间、手术时间、术中出血量、术后肾功能(术后24小时肌酐)、术后并发症、住院时间及生存随访情况等,研究分析两组手术方式的临床疗效。结果:两组肾动脉阻断时间、术中出血量、住院时间差异有统计学意义(P<0.05);两组手术时间、术后肾功能(术后24小时肌酐)、术后并发症及生存随访情况的差异均无统计学意义(P>0.05)。结论:后腹腔镜肾动脉高选择性阻断肾部分切除术患者较肾动脉全阻断肾部分切除术患者具有肾动脉阻断时限宽、术中出血量少、术后肾功能影响小及术后恢复快等优点,后腹腔镜肾动脉高选择性阻断肾部分切除术治疗肾透明细胞癌是一种可行有效的治疗方案。
Objective: To comparatively analyze the clinical effect of retroperitoneal laparoscopic high-selective renal artery occlusion and renal artery occlusion in the treatment of T1a renal clear cell carcinoma (<4cm). Methods: The clinical data of 55 cases of T1a renal clear cell carcinoma (<4cm) who underwent laparoscopic partial nephrectomy (RLPN) from January 2011 to October 2013 in our hospital were analyzed retrospectively. According to the surgical procedure, 27 cases were divided into high selective renal artery block group and 28 cases renal total block group. By comparing the renal artery occlusion time, operation time, intraoperative blood loss, postoperative renal function Postoperative 24 hours of creatinine), postoperative complications, hospitalization and survival follow-up, etc., to study and analyze the clinical efficacy of the two groups of surgical methods. Results: There was significant difference between the two groups in the time of renal artery occlusion, blood loss and length of hospital stay (P <0.05). The operation time, postoperative renal function (postoperative 24 hours), postoperative complications There was no significant difference in survival and follow-up (P> 0.05). Conclusion: The patients with retroperitoneal laparoscopic renal artery hyper-selective partial nephrectomy have a longer duration of renal artery blockage, less intraoperative blood loss, less postoperative renal function, Fast recovery after the advantages of retroperitoneal laparoscopic renal artery blocking selective partial nephrectomy for renal clear cell carcinoma is a viable and effective treatment.