摘要
目的分析输尿管尿路上皮癌患者实施完全腹腔镜下肾输尿管全长切除以及膀胱袖状切除手术作用。方法选择2013年3月—2018年3月在河北北方学院附属第一医院进行输尿管尿路上皮癌手术治疗的80例患者为研究对象,依据治疗方式不同将其分为常规组(40例)以及实验组(40例),常规组予以腹腔镜下肾输尿管切除术、膀胱袖状切除术以及开放输尿管远端治疗,实验组予以完全腹腔镜下肾输尿管全长切除以及膀胱袖状切除手术治疗。比较两组手术过程中出血量、手术时间、术后禁食时间、导尿管拔除时间、引流管拔除时间以及术后住院时间;比较两组病理分级以及病理分期、复发率及生存率、疾病预后。结果实验组手术过程中出血量低于常规组,手术时间、术后禁食时间、导尿管拔除时间、引流管拔除时间以及术后住院时间均短于常规组,差异有统计学意义(P<0.05)。两组肿瘤病理分级以及病理分期比较,差异无统计学意义(P>0.05)。两组复发率比较,差异无统计学意义(P>0.05)。经过24个月持续随访发现,实验组生存率高于常规组,差异有统计学意义(P<0.05)。结论输尿管尿路上皮癌采用完全腹腔镜下肾输尿管全长切除术以及膀胱袖状切除术治疗,可降低手术过程中出血量、促进患者术后机体康复、缩短住院时间,从而提升患者无瘤生存率,同时在手术过程中无需变换患者体位,可一定程度上减少手术时间,存在较高的有效性以及安全性,同时联合相应的护理措施可进一步提升治疗效果。
Objective To analyze the effect of total laparoscopic nephroureterectomy and bladder sleeve resection in patients with urinary tract urothelial carcinoma.Methods A total of 80 patients with ureteral urothelial carcinoma who underwent surgical treatment in the First Affiliated Hospital of Hebei North University from March 2013 to March 2018 were selected as the subjects.According to different treatment methods,they were divided into conventional group(40 cases)and experimental group(40 cases).In the conventional group,laparoscopic nephreterectomy,bladder sleeve resection and distal ureteral open treatment were performed.The experimental group was treated with total laparoscopic nephroureterectomy and bladder sleeve resection.The amount of blood loss during operation,operative time,postoperative fasting time,catheter removal time,drainage tube removal time and postoperative hospitalization time were compared between the two groups.The pathological classification and pathological stages,recurrence rate and survival rate,prognosis of disease were compared between the two groups.Results The amount of blood loss during operation in the experimental group was lower than that in the conventional group,and the operative time,postoperative fasting time,catheter removal time,drainage tube removal time and postoperative hospital stay in the experimental group were all shorter than those in the conventional group,with statistical significance(P<0.05).There was no significant difference in the pathological grade and stage between the two groups(P>0.05).There was no significant difference in recurrence rate between the two groups(P>0.05).After 24 months of continuous follow-up,the survival rate of the experimental group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).Conclusion Ureteral urothelial carcinoma using total laparoscopic renal length of ureteral resection and bladder cuff resection treatment,can reduce blood loss during operation,and promote the patients’body recovery,shorter hospital stay,and thus improve disease-free survival rate of patients,at the same time during surgery patient position without transformation,to a certain extent,reduce the operation time,has high efficacy and safety,at the same time combined the corresponding nursing measures to further enhance the efficacy of treatment.
作者
张晓林
雷茹茹
张燕茹
陈怀安
ZHANG Xiaolin;LEI Ruru;ZHANG Yanru;CHEN Huai’an(Department of Urology,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou075000,China)
出处
《中国医药导报》
CAS
2021年第9期81-85,共5页
China Medical Herald
基金
河北省卫生健康委医学科学研究计划项目(20200506)
河北省张家口市科技计划项目(1921049D)。
作者简介
通讯作者:陈怀安(1979.1-),男,硕士,副主任医师,研究方向:泌尿系肿瘤的诊治。
