经腹与经腹膜后腹腔镜保留肾单位手术对肾肿瘤患者围手术期相关指标、肾功能指标和炎性因子的影响
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陕西省咸阳市重点研发计划项目(S2022-ZDYF-SF-1062);


Effects of transabdominal laparoscopic nephron sparing surgery and retro-peritoneal laparoscopic nephron sparing surgery on perioperative indica-tors,renal function indicators,and inflammatory factors
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    摘要:

    目的:探讨经腹与经腹膜后腹腔镜保留肾单位手术(LNSS)对肾肿瘤患者围手术期相关指标、肾功能指标和炎性因子的影响。方法:选取96例行LNSS治疗的肾肿瘤患者为研究对象,根据手术路径不同将患者分为经腹组(n=46)和经腹膜后组(n=50)。经腹组患者经腹行LNSS治疗;经腹膜后组患者经腹膜后行LNSS,术后均随访6个月。比较两组患者术后围术期指标、肾功能、炎性因子及肿瘤标志物水平及并发症发生情况。结果:经腹膜后组患者手术时间、热缺血时间、术中出血量及住院时间均少于经腹组(P<0.05)。术后1、3个月,经腹膜后组尿素氮(BUN)、肌酐(Scr)水平均低于经腹组(P<0.05)。术后3 d,经腹膜后组患者血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平均低于经腹组(P<0.05);两组患者血清糖类抗原50(CA50)、癌胚抗原(CEA)水平均较术前降低(P<0.05),但组间差异无统计学意义(P>0.05)。两组患者术后并发症总发生率无统计学差异(P>0.05)。结论:与经腹入路LNSS比较,经腹膜后LNSS手术时间、热缺血时间及住院时间更短,术中出血量更少,同时有助于改善肾功能及炎性因子水平,术后并发症发生率相当。

    Abstract:

    Objective:To compare the effects of transabdominal laparoscopic nephron sparing surgery(LNSS)and retroperitone-al LNSS on perioperative indicators,renal function indicators,and inflammatory factors.Methods:96 patients with renal tumors who un-derwent LNSS were selected.According to different surgical approaches,the patients were assigned to the transabdominal group(n=46,transabdominal LNSS)and the retroperitoneal group(n=50,retroperitoneal LNSS).The two groups were compared regarding perio-perative indicators,renal function levels,inflammatory factors,and tumor markers.Results:Surgery time,warm ischemia time,intraoper-ative blood loss,and hospital stay of the retroperitoneal group were shorter and less than those of the transabdominal group(P<0.05).The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the retroperitoneal group were lower than those in the transab-dominal group at 1 month and 3 months after surgery(P<0.05).Serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in the retroperitoneal group were lower than those in the transabdominal group(P<0.05).Serum carbohydrate antigen 50(CA50)and carcinoembryonic antigen(CEA)levels in both groups on day 3 after surgery were lower than preoperative levels(P<0.05),but there was no significant difference between groups(P>0.05).There was no significant difference in the total incidence of postoperative complications between groups(P>0.05).Conclusion:Compared with transabdominal LNSS,ret-roperitoneal LNSS has advantages in shorter surgery time,warm ischemia time,hospital stay,intraoperative blood loss.It also can help to improve renal function and inflammatory factor levels in patients with renal tumors,with a similar incidence of complications of postoper-ative complications.

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陈思奎;闫家文;王传亮;殷峪;.经腹与经腹膜后腹腔镜保留肾单位手术对肾肿瘤患者围手术期相关指标、肾功能指标和炎性因子的影响[J].川北医学院学报,2025,40(4):497-500.

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  • 在线发布日期: 2025-07-24
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