Retroperitoneal Laparoscopic Radical Nephrectomy And Open Renal Cell Carcinoma Comparison Of Clinical Effects Of Radical Mastectomy

Objective: Comparison of laparoscopic radical nephrectomy(Laparoscopic radical nephrectomy) and traditional open radical nephrectomy(Open radical nephrectomy) clinical effect of T1-T3 a renal cell carcinoma.Methods: from January 2013 to January 2015 during Henan province people’s hospital Urology admitted by pathologically confirmed renal cell carcinoma clinical data of 280 cases of hospitalized patients, depending on the choice of treatment of 280 patients with surgical programs were divided the observation group(n = 158) and control group(n = 122), patients in the observation group after selection by intraperitoneal laparoscopic radical nephrectomy, the control group patients choose traditional open abdominal cavity after radical nephrectomy, surgical patients were recorded time, blood loss, postoperative local pain(VAS score), postoperative exhaust time, postoperative drainage tube indwelling time, postoperative indwelling catheter time, postoperative hospital stay, incidence of postoperative complications, The recurrence rate within six months of the situation and other indicators, statistical analysis of the comparison. Observation group 158 cases of patients based on tumor size, divided into two groups A(tumor diameter <3.0cm, n = 80) and observation group B(tumor diameter ≥3.0cm, n = 70), comparing the operative time, blood loss the amount of conversion to open rate, postoperative pain(VAS score), postoperative recovery of gastrointestinal function and other indicators, parallel statistical comparison.Results: The observation group, 8 patients were converted to open surgery procedure, and more than 150 examples of the observed object, operation time(122.4 ± 15.6) min, blood loss(170.5 ± 43.8) ml, 24 h after surgery pain VAS score(43.6 ± 9.0) points, postoperative discharge time(21.5 ± 3.0) h, postoperative peritoneal drainage tube indwelling time(2.8 ± 0.7) d, postoperative indwelling catheter time(3.1 ± 1.4) d, postoperative d, above indicators compared with the control group, the difference in length of stay(6.0 ± 1.2) are present statistical significance(P <0.05); bleeding patients in the observation group, infections, skin healing and other complications there were 11 cases, the incidence of 7.3%(11/150) in the control group was 11.5%(14/122) in the observation group was dominant(P <0.05); 6-month follow-up, patients in the observation group tumor recurrence or metastasis in 16 cases, the incidence of 10.6 %(16/150) in the control group was 10.7%(13/122), the difference was not statistically significant(P> 0.05); conversion to open surgical Eight patients in the observation group a accounted for 4 cases, the rate of 4.8%(4/84) in the observation group B accounted for 4 cases, the incidence of 5.4%(4/74), the difference was not statistically significant(P> 0.05). Observation of group A and group B patients also observed in operative time, aspects, blood loss, postoperative pain scores, postoperative discharge time difference is small, not statistically significant(P> 0.05).Conclusion: Laparoscopic radical nephrectomy and open radical nephrectomy is the treatment of both T1-T3 a renal cell carcinoma effective surgery program, laparoscopic surgery program fine surgical procedures, shorter operative time, intraoperative small side injury, surgery after rapid recovery, postoperative quality of life was significantly better than open surgical procedures were; for the operation of a skilled surgeon, laparoscopic large volume of small tumors and tumor volume is not very different treatment, laparoscopic radical nephrectomy is equally applicable in bulky tumors were.