目的

比较经腹膜后途径单孔腹腔镜与多孔腹腔镜肾部分切除术治疗肾肿瘤的临床效果。

方法

回顾性分析我院2021 年7 月至2023 年3 月期间分别采用腹膜后多孔和单孔肾部分切除术的肾肿瘤患者临床资料，多孔组22 例，单孔组20 例。比较两组术中手术时间、术中失血量、术后引流量等围手术期临床指标。

结果

两组在手术时间、术中出血量、术中热缺血时间、肿瘤切除时间、创面缝合时间、术后3 d 总引流量、术后肛门通气时间、术后血红蛋白下降和肌酐上升水平上差异无统计学意义。但在体表切口总长度和疼痛评分上，单孔组优于多孔组（P＜0.001）。两组病例术后病理切缘均为阴性。单孔组和多孔组肾恶性肿瘤病例随访时间分别为（18.9±5.0）月和（18.7±5.7）月，差异无统计学意义，随访期间均未出现局部复发和远处转移病例。

结论

经腹膜后多孔和单孔腹腔镜肾部分切除术是安全、可行、有效的。但对于患者来说，在疼痛及术后切口疤痕上，单孔优于多孔，患者更容易接受。

Objective

To compare perioperative outcomes of retroperitoneal single-port and multi-port laparoendoscopic partial nephrectomy for renal tumor.

Methods

The clinical data of patients with renal tumors who underwent retroperitoneal multi-port or single-port partial nephrectomy from July 2021 to March 2023 were retrospectively analyzed， including 22 patients in the multi-port group and 20 patients in the single-port group.The perioperative clinical indicators such as operation time， perioperative bleeding and postoperative diversion were compared between the two groups.

Results

There was no significant difference between the two groups in operation time， perioperative bleeding，warm ischemia time， time for tumor resection， time for suture wound， total drainage volume three days after operation，anal exsufflation time， hemoglobin decrease and serum creatinine increase.However， the total length of incision and postoperative pain score were less in the single-port group than multi-port group （P＜0.001）.The positive surgical margins were negative in both groups.The follow-up time of renal malignant tumors in single-site group and multi-site group was （18.9±5.0） months and （18.7±5.7） months， respectively， with no significant difference.No local recurrence or distant metastasis occurred during the follow-up period.

Conclusion

Retroperitoneal laparoscopic partial nephrectomy with multiple-port or single-port is safe，feasible and effective.But for patients， single-port is better than multi-port in pain and postoperative incision scar， which is easier for patients to accept.