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腹腔镜与开放性根治性肾切除术后的生活质量调查

Quality of life survey following laparoscopic and open radical nephrectomy.

作者信息

Acar Cenk, Bilen Cenk, Bayazit Yildirim, Aslan Guven, Koni Artan, Basok Erem, Kaplan Mustafa

机构信息

Department of Urology, Acibadem University Faculty of Medicine, Istanbul, Turkey.

Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey..

出版信息

Urol J. 2014 Nov 30;11(6):1944-50.

Abstract

PURPOSE

To compare the quality of life (QoL) of renal cancer patients following laparoscopic and open radical nephrectomy.

MATERIALS AND METHODS

Seventy-two (64.9%) patients who were treated with open radical nephrectomy (ORN group) and 39 (35.1%) patients who were treated with laparoscopic radical nephrectomy (LRN group) were included in this study. QoL was evaluated by Short Form-36 (SF-36) physical domain scores obtained before surgery, 1 and 6 months after surgery. Analgesic requirement and visual analog scale (VAS) pain scores following surgeries were recorded.

RESULTS

The demographic features of the groups were similar. There was a significant difference in tumor size be­tween the ORN group (71.59 & plusmn; 29.83 mm) and LRN group (57.08 & plusmn; 19.33 mm) (P = .011). In the LRN group there was less blood loss, a lower transfusion rate, earlier ambulation, more rapid convalescence and shorter hospitalization; however, the difference in surgical duration between the ORN group (122.86 & plusmn; 36.8 min) and LRN group (140.17 & plusmn; 50.71 min) was not significant (P = .383). Analgesic requirement and VAS pain scores were similar in both groups. In terms of SF-36 physical domain scores, the general health perception score in the LRN group was higher than that in the ORN group at pre-surgery, 1 and 6 months after surgery. SF-36 physical functioning and general health perception scores in both groups were significantly lower in 1 month after surgery and were higher in 6 months after surgery, as compare to before surgery. Bodily pain scores in LRN group did not change significantly after surgery (P = .376).

CONCLUSION

LRN exhibited some technical advantages, including less blood loss, shorter hospitalization and more rapid recovery. Although the ORN patients had relatively larger tumors, analgesic requirement, postoperative complications, body pain, and physical functioning weren't significantly different between the groups. QoL was higher 6 months after surgery than before surgery in both groups. & nbsp;

摘要

目的

比较腹腔镜根治性肾切除术和开放性根治性肾切除术后肾癌患者的生活质量(QoL)。

材料和方法

本研究纳入72例(64.9%)接受开放性根治性肾切除术的患者(ORN组)和39例(35.1%)接受腹腔镜根治性肾切除术的患者(LRN组)。通过术前、术后1个月和6个月获得的简明健康状况调查量表(SF-36)躯体领域评分评估生活质量。记录术后镇痛需求和视觉模拟评分(VAS)疼痛评分。

结果

两组的人口统计学特征相似。ORN组(71.59±29.83mm)和LRN组(57.08±19.33mm)的肿瘤大小存在显著差异(P = 0.011)。LRN组术中出血更少、输血率更低、下床活动更早、恢复更快且住院时间更短;然而,ORN组(122.86±36.8分钟)和LRN组(140.17±50.71分钟)的手术时间差异不显著(P = 0.383)。两组的镇痛需求和VAS疼痛评分相似。就SF-36躯体领域评分而言,LRN组术前、术后1个月和6个月的总体健康感知评分均高于ORN组。与术前相比,两组术后1个月的SF-36躯体功能和总体健康感知评分均显著降低,术后6个月升高。LRN组术后躯体疼痛评分无显著变化(P = 0.376)。

结论

LRN显示出一些技术优势,包括出血更少、住院时间更短和恢复更快。尽管ORN组患者的肿瘤相对较大,但两组之间的镇痛需求、术后并发症、身体疼痛和躯体功能无显著差异。两组术后6个月的生活质量均高于术前。

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