腹腔镜保留肾单位肾肿瘤切除术对肾细胞癌患者肾功能和预后的影响

Impact of laparoscopic nephron-sparing nephrectomy on renal function and prognosis in patients with renal cell carcinoma

摘要:

目的 分析肾细胞癌患者接受腹腔镜保留肾单位肾肿瘤切除术治疗对其肾功能及预后的影响。方法 收集2017年1月至2022年3月重庆医科大学附属第一医院泌尿外科接诊的肾细胞癌患者182例作为研究对象，采取随机法将患者进行分组，一组应用腹腔镜根治性肾切除术进行治疗，共91例为对照组，另一组应用腹腔镜保留肾单位肾肿瘤切除术进行治疗，共91例为研究组，对比两组患者术后肾功能及预后效果差异性。结果 研究组患者术后住院时间（P=0.011）优于对照组，对照组患者手术期间出血量（P<0.001）及手术时间（P=0.019）优于研究组，差异均有统计学意义；研究组患者手术后24 h血清肌酐水平（P=0.013）低于对照组，差异有统计学意义；研究组患者术后认知功能（P=0.018）、躯体功能（P=0.021）、社会功能（P=0.025）、情绪功能（P=0.032）及总体生活质量（P=0.033）等各维度评分高于对照组，差异有统计学意义。结论 临床中为肾细胞癌患者提供腹腔镜保留肾单位肾肿瘤切除术进行治疗可以缓解对患者肾功能造成的影响，提升患者手术治疗后的生活质量水平。

Abstract:

Objective To analyze the impact of laparoscopic nephron-sparing nephrectomy on renal function and prognosis in patients with renal cell carcinoma.Methods A total of 182 patients with renal cell carcinoma in Department of Urology，The First Affiliated Hospital of Chongqing Medical University were enrolled from January 2017 to March 2022. The patients were randomly assigned to undergo laparoscopic radical nephrectomy（control group，91 patients） or laparoscopic nephron-sparing nephrectomy（study group，91 patients）. Postoperative renal function and prognosis of the two groups were compared.Results The study group was significantly better than the control group in the length of hospital stay（P=0.011），and the control group was significantly better than the study group in intraoperative bleeding volume（P<0.001） and operation time（P=0.019）. Compared with the control group，the study group showed a significantly lower serum creatinine level 24 hours after surgery（P=0.013） and significantly higher scores of cognitive function（P=0.018），physical function（P=0.021），social function（P=0.025），emotional function（P=0.032），and overall quality of life（P=0.033） after surgery.Conclusion Laparoscopic nephron-sparing nephrectomy can lessen the impact on renal function and improve postoperative quality of life for patients with renal cell carcinoma.