Kadji J F, Armand C, Gimbergues P, Blanc F, Tostain J
Service d'Urologie-Andrologie, Hôpital Nord, Saint-Etienne, France.
Prog Urol. 2001 Apr;11(2):223-30.
To evaluate the results of radical retroperitoneal laparoscopic nephrectomy in terms of tolerance, morbidity and oncologic control.
22 radical nephrectomies have been carried out by retroperitoneal laparoscopy. One surgical conversion has been necessary. This series has been retrospectively compared to 16 radical nephrectomies by open surgery.
Both series were comparable. Operative time was not significantly different in the two groups. Blood loss was less with laparoscopic surgery (p < 10-3). We did not see any difference in antalgic consumption during the first post-operative day and in intensive care and hospital stay. Post-operative complications were less in the laparoscopy group (p = 0.04). We observed no death or reccurrence with a mean follow-up of 8.7 months for the laparoscopy group vs 32.2 for the open group.
Radical retroperitoneal laparoscopic nephrectomy is a recent surgical technique which has the same oncologic standards as open surgery. Blood loss and post-operative complications are significantly reduced. Survival needs to be evaluated on long term follow-up.
从耐受性、发病率和肿瘤学控制方面评估根治性腹膜后腹腔镜肾切除术的效果。
通过腹膜后腹腔镜进行了22例根治性肾切除术。有1例需要转为开放手术。该系列病例与16例开放手术的根治性肾切除术进行了回顾性比较。
两个系列具有可比性。两组手术时间无显著差异。腹腔镜手术失血更少（p < 10⁻³）。我们在术后第一天、重症监护期间和住院时间方面未发现镇痛药物使用有任何差异。腹腔镜组术后并发症更少（p = 0.04）。腹腔镜组平均随访8.7个月，开放组平均随访32.2个月，均未观察到死亡或复发。
根治性腹膜后腹腔镜肾切除术是一种新的手术技术，其肿瘤学标准与开放手术相同。失血和术后并发症显著减少。生存情况需要通过长期随访进行评估。
