Comparation Study Of Retroperitoneal Laparoscopy Combined With Little Abdominal Incision And Open Nephroureterectomy For Treatment Of The Carcinoma Of Renal Pelvis

Objective: To compare the clinical efficacy of retroperitoneal laparoscopycombined miner abdominal incision and open nephroureterectomy for treating thecarcinoma of renal pelvis.Methods: Retrospective analysis clinical data of52cases renal pelvis carcinomaby surgical treatment and postoperative pathologic diagnosis from Fujian MedicalUniversity attached Xiehe Hospital urinary surgical department from January2006to November2012,21cases（group A） by retroperitoneal laparoscopy combinedminer abdominal incision, open nephroureterectomy31cases（group B）.Wecompared the operating time, intraoperative blood loss, drainage duration, recoverytime of intestine function and postoperative hospital stay between two groups. All thecases were followed up for6-65months and bladder carcinoma recurrence,tumormetastasis were recorded. respectively. The clinical data and follow-up data wasrecorded for two groups and analyzed statistically.Results: All operations were completed successfully,no death occurred andthere was no conversion to open surgery in the group A. Age, gender, the bodyweight, body mass index,the tumor size and the location of the tumor were notsignificantly difference in the two groups(P＞0.05); The intraoperative blood loss（106.4±68.1ml vs334.3±362.7ml，p=0.002）, the recovery time of intestinefunction（1.9±0.8d vs3.0±0.9d，p<0.001）,the time of using hemostatic（3.7±1.5dvs5.1±2.4d，p=0.011）, the time of using acesodyn（e2.6±0.7d vs4.9±2.3d，p<0.001）and postoperative hospital stay（9.8±2.7d vs12.6±4.6d;p=0.009） in the group A wereless than those in the group B；The operative time(198.0±42.2min vs220.7±42.6min，p=0.062), The time of indwelling retroperitoneal drainage tube(4.9±2.0d vs5.3±2.2d，p=0.555)， the time of indwelling iliac fossa drainage tube（6.0±1.8d vs5.0±1.9d，p=0.114）and catheter(7.4±2.8d vs7.0±2.7d，p=0.638),the frequencyof postoperative complication (19.0%vs25.8%， p=0.571) were not significantlydifference in the two groups. A group of follow-up time is35.7±12.2month, B groupof follow-up time is33.9±14.1month,they were not significantly difference （P=0.527）; The recurrence rate of local tumor,bladder carcinoma and tumormetastasis were not significantly difference in the two groups (P＞0.05).Conclusions: Compared with traditional open surgery, retroperitoneal laparoscopycombined miner abdominal incision has the advantages of less wound, less blood loss,rapid recovery, reducing the patients suffering, shorten the length of hospitalizationand didn’t increase the recurrence of bladder carcinoma, fitting the surgery principleof tumor radical treatment. It has become an ideal surgical technique for treating thecarcinoma of renal pelvis.