Comparison Of Laparoscopic And Open Nephron-sparing Surgery For T1a Renal Cell Carcinoma

Objective:To evaluate the treatment of T1 a renal cell carcinoma between laparoscopic nephron-sparing surgery(LNSS) and open nephron-sparing surgery(ONSS).Method:The clinical data of 60 cases including LNSS patients(n=29) and ONSS patients(n=31) from the First Clinical Hospital of Shanxi Medical University during November2009 to October 2013 were into A retrospective analysis,comparison were made in clinical indexes between Kidney hot ischemia time, operative time, peri-operative bleeding,postoperative drainage, The length of the incision, The postoperative hospitalization days and so on. Used SAS9.2 statistical software,the data of this research obeyed normal distribution, sx ± is used to describ measurement data, the two samples compared with t test; And take frequency to describ enumeration data. Based on the difference of the probability is less than 0.05 was statistically significant.Result:1. There was no statistical difference between the two groups in age, gender, tumor size,tumor side etc(P>0.05).2. The LNSS group was more than the ONSS group in the average of kidney hot ischemia time(LNSS:24.4±2.5min, ONSS :15.7±2.9min).The differences of the two groups have statistical significance(P<0.05).3. The LNSS group was significantly less than the ONSS group in the average of operative time(LNSS:88.9±13.1min,ONSS:130.6±13.5min).The differences of the two groups have statistical significance(P<0.05).4. The mean drainage days of the LNSS group are similar to the ONSS group(LNSS:3.4±1.1d, ONSS:3.4±0.8d). There was no statistically significant in the difference of the two groups(P>0.05).Conclusion:The two kinds of operation methods have their advantages and disadvantages.Compared with ONSS group, LNSS is not only a kind of higher security surgery with little trauma, lower postoperative pain score and shorter operative time, but also a larger degree of protection of the nephron and renal function, it can be a better way to treat T1 a renal cell carcinoma. But it requires special equipment, high technology, higher treatment costs,long learning time.