不同腹腔镜术式治疗上尿路尿路上皮癌的临床疗效比较
Comparison of different laparoscopic treatments for upper urinary tract urothelial carcinoma
朱猛 1谷军飞 1柳跃鹏 1李子豪 1马超 1任立新1
作者信息
- 1. 河北医科大学第二医院泌尿外科,河北石家庄 050000
- 折叠
摘要
目的 比较经腹腹腔镜单一体位肾输尿管全长切除术(PSPNTLR)与后腹腔镜下腹部切口技术(PLSIT)治疗上尿路上皮癌(UTUC)的临床疗效.方法 选取2018年1月 2021年2月河北医科大学第二医院收治的82例UTUC患者作为研究对象,采用随机数字表法将患者分为观察组(给予PSPNTLR治疗)和对照组(给予PLSIT治疗)各41例.比较两组患者围术期指标、疼痛程度、炎症因子水平和膀胱内复发和远处转移情况.结果 两组的手术时间[(122.15±15.14)min vs.(160.88±17.26)min]、住院时间[(10.07±2.14)d vs.(12.22±3.13)d]和术后排气时间[(1.46±0.57)d vs.(3.10±0.88)d]相比,观察组均明显短于对照组,两组的术中出血量[(42.85±4.88)mL vs.(78.22±8.17)mL]、引流量[(53.61±9.74)mL vs.(81.56±11.06)mL]相比,观察组均明显少于对照组(P＜0.05).观察组术后6、12及24 h的视觉模拟评分(VAS)均显著低于对照组(P＜0.05).术后1 d两组患者的白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均上升,但对照组指标上升更显著(P＜0.05).术后2年的随访期内,两组患者的膀胱内复发(12.20％vs.14.63％)和远处转移情况(9.76％vs.4.88％)比较差异无统计学意义(P＞0.05)o结论 PSPNTLR与PLSIT治疗UTUC均有良好的安全性,但PSPNTLR在改善患者围术期指标、减轻患者术后疼痛、抑制机体炎症反应方面效果更优.
Abstract
Objective To compare the clinical efficacy of peritoneolaparoscopic single position nephreteral total length resection(PSPNTLR)and posterior laparoscopic subabdominal incision technique(PLSIT)in the treatment of upper urothelial carcinoma(UTUC).Methods A total of 82 UTUC patients treated in our hospital during Jan.2018 and Feb.2021 were divided into the observation group(n=41,treated with PSPNTLR)and control group(n=41,treated with PLSIT)according to the random number table method.Perioperative indicators,pain degree,inflammatory factors,bladder recurrence and distant metastasis were compared between the two groups.Results The operation time[(122.15±15.14)min vs.(160.88±17.26)min],hospitalization time[(10.07±2.14)d vs.(12.22±3.13)d]and postoperative exhaust time[(1.46±0.57)d vs.(3.10±0.88)d]were significantly shorter,the intraoperative blood loss[(42.85±4.88)mL vs.(78.22±8.17)mL]and drainage volume[(53.61±9.74)mL vs.(81.56±11.06)mL]were significantly less in the observation group than in the control group(P＜0.05).The visual analogue score(VAS)of the observation group at 6,12 and 24 h after operation was significantly lower than that of the control group(P＜0.05).The levels of interleukin-6(IL-6)and C-reactive protein(CRP)were increased in both groups one day after surgery,but the indexes were increased more significantly in the control group(P＜0.05).During the 2-year follow-up after surgery,there were no statistical difference in bladder recurrence(12.20％vs.14.63％)and distant metastasis(9.76％vs.4.88％)between the two groups(P＞0.05).Conclusion Both PSPNTLR and PLSIT have good therapeutic safety,but PSPNTLR is more effective in improving perioperative indicators,reducing postoperative pain,and inhibiting inflammatory factors.
关键词
经腹腹腔镜单一体位肾输尿管全长切除术/后腹腔镜下腹部切口技术/上尿路上皮癌Key words
peritoneolaparoscopic single position nephreteral total length resection/posterior laparoscopic subabdominal incision technique/upper tract urothelial carcinoma引用本文复制引用
基金项目
河北省医学科学课题计划项目(20230590)
出版年
2024
NETL
NSTL
万方数据