Clinical study of totally laparoscopic treatment for upper urinary tract urothelial carcinoma under a single position

doi:10.3877/cma.j.issn.1674-3253.2019.01.011

Abstract

Abstract:

Objective

To investigate the clinical efficacy of totally laparoscopic treatment for upper urinary tract urothelial carcinoma (UUTUC) which under a single position.

Methods

Eighty nine UUTUC patients were enrolled from Jan. 2016 to Jun. 2017. The prospective clinical controlled analysis method was adopted in our study. All patients were divided into test group and control group according to the random number table. Fourty five cases (test group) underwent totally laparoscopic nephroureterectomy with single position, while 44 cases (control group) received retroperitoneal laparoscopy combined with hypogastric oblique incision to treat the UUTUC. The differences between the two groups in perioperative related indicators and tumor recurrence rate were compared. And the clinical effect of neo-surgical treatment of UUTUC was analyzed.

Results

All the 89 operations for UUTUC were successful without conversion to open surgery. No obvious complications occurred during perioperative period. The average operation time in the test group was shorter (96.6±8.6) min versus (147.5±9.2) min, the blood loss was less (39.6±4.2) ml versus (46.5±4.6) ml, the leaving bed time was shorter (7.5±1.0) h versus (11.4±1.8) h, the hospital stay was shorter (7.0±1.1) d versus (9.9±1.5) d), and the difference were significant (P<0.05). There were no significant difference in tumor stage, tumor grade, the recovery time of postoperative gastrointestinal function, follow-up time and the difference of tumor recurrence rate between the 2 groups.

Conclusion

Compared with the traditional surgical methods, the totally laparoscopic treatment for UUTUC which under a single position has advantages of shorter operation time, less blood loss and shorter leaving bed time. The new operative method could shorten the hospital stay and accelerate recovery of patients, and it is a viable surgical procedure which deserved application and promotion in clinical work.

Key words: Single position, Laparoscopic, UUTUC, Prospective, Random

Xuebao Zhang, Ke Wang, Qiqiang Zhang, Haiwei Zhao, Chu Liu. Clinical study of totally laparoscopic treatment for upper urinary tract urothelial carcinoma under a single position[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(01): 45-48.

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Figures/Tables 2

References 15

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组别	例数	年龄（岁，±s）	性别（例）		侧别（例）		肿瘤位置（例）		肿瘤分期（例）			肿瘤分级			手术时间（min，±s）
组别	例数	年龄（岁，±s）	男	女	左	右	肾盂	输尿管	T₁	T₂	T₃	G₁	G₂	G₃	手术时间（min，±s）
实验组	45	66±6	24	21	19	26	31	14	21	17	7	16	23	6	97±9
对照组	44	66±3	23	21	21	23	29	15	20	18	6	14	25	5	147±9
统计值	?	t=0.116	χ²=0.010		χ²=0.272		χ²=0.090		χ²=0.119			χ²=0.296			t=-27.112
P值	?	0.908	0.920		0.602		0.764		0.942			0.862			<0.001
组别	例数	术中出血量（ml，±s）	胃肠功能恢复时间（min，±s）	术后首次下床活动时间（h，±s）	住院时间（d，±s）	随访时间（月，±s）	肿瘤复发（例）
组别	例数	术中出血量（ml，±s）	胃肠功能恢复时间（min，±s）	术后首次下床活动时间（h，±s）	住院时间（d，±s）	随访时间（月，±s）	肾盂肿瘤	输尿管肿瘤
实验组	45	40±4	6.5±1.1	7.5±1.0	7.0±1.1	26±5	0	1
对照组	44	46±5	6.4±1.1	11.4±1.8	9.9±1.5	26±5	2	3
统计值	?	t=-7.475	t=0.354	t=-12.514	t=-10.265	t=-0.040	-	-
P值	?	<0.001	0.724	<0.001	<0.001	0.968	0.229	0.598

组别	例数	年龄（岁，±s）	性别（例）		侧别（例）		肿瘤位置（例）		肿瘤分期（例）			肿瘤分级			手术时间（min，±s）
组别	例数	年龄（岁，±s）	男	女	左	右	肾盂	输尿管	T₁	T₂	T₃	G₁	G₂	G₃	手术时间（min，±s）
实验组	45	66±6	24	21	19	26	31	14	21	17	7	16	23	6	97±9
对照组	44	66±3	23	21	21	23	29	15	20	18	6	14	25	5	147±9
统计值	?	t=0.116	χ²=0.010		χ²=0.272		χ²=0.090		χ²=0.119			χ²=0.296			t=-27.112
P值	?	0.908	0.920		0.602		0.764		0.942			0.862			<0.001
组别	例数	术中出血量（ml，±s）	胃肠功能恢复时间（min，±s）	术后首次下床活动时间（h，±s）	住院时间（d，±s）	随访时间（月，±s）	肿瘤复发（例）
组别	例数	术中出血量（ml，±s）	胃肠功能恢复时间（min，±s）	术后首次下床活动时间（h，±s）	住院时间（d，±s）	随访时间（月，±s）	肾盂肿瘤	输尿管肿瘤
实验组	45	40±4	6.5±1.1	7.5±1.0	7.0±1.1	26±5	0	1
对照组	44	46±5	6.4±1.1	11.4±1.8	9.9±1.5	26±5	2	3
统计值	?	t=-7.475	t=0.354	t=-12.514	t=-10.265	t=-0.040	-	-
P值	?	<0.001	0.724	<0.001	<0.001	0.968	0.229	0.598

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