The Efficacy Comparison Between Retroperitoneal Laparoscopy Combined Ureteral Resectoscope And Open Surgery For The Treatment Of Upper Tract Malignant Tumors

Objective To evaluate the clinical efficacy of retroperitoneal laparoscopy combined urethral resectoscope for the treatment of upper tract malignant tumors.Methods Retrospective analysis clinical data of 48 cases renal pelvis or ureteral urothelial carcinoma by surgical treatment and postoperative pathologic diagnosis from Ningxia Medical University hospital uropoiesis surgical department from January 2006 to December 2010,18 cases by retroperitoneal laparoscopy comined urethral resectoscop ,open surgery 30 cases.We compare the operative time,intraoperative blood loss,postoperative drainage,pulling drainage tube time,postoperative gastrointestinal function recovery time and postoperative hospital stay between two groups.All the cases were followed up for 3-60 months and the survival rates,bladder carcinoma recurrence were recorded.Results All operations were completed successfully,no death occurred and there was no conversion to open surgery in group A.The mean operative time was (135±31)min in group A and (174±57)min in group B(P<0.05);The mean intraoperative blood loss amount was (119±35)ml in group A and (159±71)ml in group B(P<0.05);The mean postoperative drainage amount was (106±28)ml in group A and (118±23)ml in group B(P>0.05);The mean postoperative gastrointestinal function recovery time was (2.1±0.7)d in group A and (2.7±0.8)d ingroup B(P<0.05);The mean pulling drainage tube time was (3.8±0.8)d in group A and (4.3±1.1)d in group B(P>0.05);The mean postoperative hospital stay was (8.4±0.9)d in group A and (9.7±2.1)d ingroup B(P<0.05).The mean operative time in group A was shorter than those in group B(P<0.05).The mean intraoperative blood loss amount in group A were less than those in group B(P<0.05).The mean postoperative gastrointestinal function recovery time in group A was shorter than in group B(P<0.05).The mean postoperative hospital stay in group A was shorter than in group B(P<0.05).The mean postoperative drainage amount and the mean pulling drainage tube time were not significantly different in two groups(P>0.05).The recurrence of bladder carcinoma was not significantly different in two groups(P>0.05).Conclusions Compared with traditional open surgery,retroperitoneal laparoscopy combined urethral resectoscope nephroureterectomy has the advantages of less time,less wound,less blood loss,rapid recovery etc,reducing the patients suffering,shorten the length of hospitalization and didn't increase the recurrence of bladder carcinoma,fitting the surgery principle of tumor radical treatment,minimally invasive and effective.