不同腹腔鏡術(shù)式治療上尿路尿路上皮癌的臨床療效比較

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Comparison of different laparoscopic treatments for upper urinary tract urothelial carcinoma

ZHU Meng，GU Junfei，LIU Yuepeng，LI Zihao，MA Chao，REN Lixin

（Department of Urology，The Second Hospital of Hebei Medical University，Shijiazhuang 050000，China）

ABSTRACT：Objective

To compare the clinical efficacy of peritoneolaparoscopic single position nephreteral total length resection （PSPNTLR） and posterior laparoscopic subabdominal incision technique （PLSIT） in the treatment of upper urothelial carcinoma （UTUC）.Methods A total of 82 UTUC patients treated in our hospital during Jan.2018 and Feb.2021 were divided into the observation group （n=41，treated with PSPNTLR） and control group （n=41，treated with PLSIT） according to the random number table method.Perioperative indicators，pain degree，inflammatory factors，bladder recurrence and distant metastasis were compared between the two groups.Results The operation time [（122.15±15.14） min vs.（160.88±17.26） min]，hospitalization time [（10.07±2.14） d vs.（12.22±3.13） d] and postoperative exhaust time [（1.46±0.57） d vs.（3.10±0.88） d] were significantly shorter，the intraoperative blood loss [（42.85±4.88） mL vs. （78.22±8.17） mL] and drainage volume [（53.61±9.74） mL vs.（81.56±11.06） mL] were significantly less in the observation group than in the control group （P<0.05）.The visual analogue score （VAS） of the observation group at 6，12 and 24 h after operation was significantly lower than that of the control group （P<0.05）.The levels of interleukin-6 （IL-6） and C-reactive protein （CRP） were increased in both groups one day after surgery，but the indexes were increased more significantly in the control group （P<0.05）.During the 2-year follow-up after surgery，there were no statistical difference in bladder recurrence （12.20% vs.14.63%） and distant metastasis （9.76% vs.4.88%） between the two groups （P>0.05）.Conclusion Both PSPNTLR and PLSIT have good therapeutic safety，but PSPNTLR is more effective in improving perioperative indicators，reducing postoperative pain，and inhibiting inflammatory factors.

KEY WORDS：peritoneolaparoscopic single position nephreteral total length resection；posterior laparoscopic subabdominal incision technique；upper tract urothelial carcinoma

摘要：目的 比較經(jīng)腹腹腔鏡單一體位腎輸尿管全長切除術(shù)（PSPNTLR）與后腹腔鏡下腹部切口技術(shù)（PLSIT）治療上尿路上皮癌（UTUC）的臨床療效。（剩余7624字）