Comparison Of Clinical Efficacy Between Retroperitoneal Laparoscopy Nephroureterectomy Combined With The Abdominal Incision And Open Nephroureterectomy For Treating The Transitional Cell Carcinoma Of Upper Urinary Tract And Risk Factors Of The Occurrence

Objective To compare the clinical efficacy of retroperitoneal laparoscopy nephroureterectomy and open nephroureterectomy for treating the transitional cell carcinoma of upper urinary tract, to provide the reference of further treatment postoperatively to reduce tumor recurrence of the patients.To analysis the influence factors on bladder tumor recurrence after operation.Methods 38 patients with transitional cell carcinoma of upper urinary tract underwent retroperitoneal laparoscopy nephroureterectomy and other 36 patients underwent open nephroureterectomy synchronization 。 The two groups had no statistically significant in patient age,gender,,tumor stage and size difference. To compare the clinical curative effect of two groups of patients and postoperative complications.We focus on peri operation period data(operation time,bleeding volume during the operation,the recovery time of intestine function,postoperative drainage,the time of removal of T-tube drainage after operation, the time of hospitalization afteroperation, complication surround operation period, etc.) statistical analyses.According to the oncology index(local recurrence of bladder tumor recurrence,incision, planting, distant metastasis, survival time) of the patients were followed up for 3-60 months, compared with two groups of bladder tumor recurrence, survival rate.To study the influencing factors of the recurrence of bladder cancer in patients with gender, age and from the tumor site, tumor stage and grade, postoperative bladder perfusion therapy for 74 patients after radical resection.Results All operations were completed successfully,no death occurred and there was no conversion to open surgery in group A. Retroperitoneal laparoscopic group in the average operation time, bleeding volume during operation, anal exhaust time, postoperative hospital stay is superior to open operation, and has statistical significance; and in the postoperative drainage and postoperative drainage tube removal time etc(P<0.05). Although and open operation group has difference but there was no statistical significance(P > 0.05). Although there are differences in the aspects of tumor recurrence and open operation group but without statistical significance(P > 0.05).Tumor stage and grade, postoperative intravesical therapy and lower ureteral cancer were risk factors of the recurrence of bladder cancer.Conclusion Retroperitoneal laparoscopy nephroureterectomy has the advantages of less wound,less blood loss,less complications,complete specimen,rapid recovery and fitting the surgery principle of tumor radical treatment etc. It has become an ideal surgical technique for treating the transitional cell carcinoma of upper urinary tract. Upper urinary tract transitional cell carcinoma, especially the lower ureteral patients, postoperative need rules intravesical therapy and close follow-up, early prevention and treatment of bladder tumor.