Comparison Of The Clinical Efficacy Of Retroperitoneal Laparoscopy Combined With Small Abdominal Incision And Open Nephroureterectomy In The Treatment Of Renal Pelvis(Ureter) Carcinoma(Report Of 103 Cases)

Objective:To compare the clinical efficacy of retroperitoneal laparoscopy combined with small abdominal incision and open nephroureterectomy in the treatment of renal pelvis(ureter)carcinoma.Methods: Data on a total number of 103 cases of patients who underwent nephroureterectomy surgery for renal pelvis(ureter)carcinoma in the Department of Urology at The First Affiliated Hospital of Guangxi Medical University were collected from March 2003 to October 2016.The postoperative pathological diagnosis was confirmed to be renal pelvis(ureter)cancer.According to the method of operation,the 103 cases were divided into two groups: 56 cases in the retroperitoneal laparoscopy combined with small abdominal incision group(Group A)and 47 cases of traditional open surgery group(Group B).Information such as gender,age,weight,operation time,intraoperative blood loss,postoperative complications,the duration of the use of painkiller postoperatively,the duration of the use of hemostatic agentspostoperatively,the duration before recovery of intestinal function after operation,and the length of hospital stay after operation of the two groups were collected,compared and analyzed.The follow-up period was 3 months to 65 months.The distant metastasis and the recurrence of bladder tumor of the two groups were also compared and analyzed.Results: The surgery in both Group A and Group B were successfully completed with no death cases reported.Not a single case in Group A required to transfer to traditional open surgery.There were no significant differences in gender,age,body weight and tumor size between the two groups(p>0.05).The data of group A were as follows: intraoperative blood loss(161.3±91.2)ml,duration of the use of painkiller postoperatively(1.6±1.3)d,duration of the use of hemostatic agents postoperatively(2.2±1.2)d,duration before recovery of intestinal function after operation(3.3±1.8)d,length of hospital stay after operation(8.8±2.6)d,and duration on intravenous antibiotic after operation(8.2±2.6)d.And for Group B: intraoperative blood loss(264.3±159.3)ml,duration of the use of painkiller postoperatively(1.5 ±1.3)d,duration of the use of hemostatic agents postoperatively(2.2 ± 1.1)d,duration before recovery of intestinal function after operation(3.2± 1.9)d,length of hospital stay after operation(11.3±3.6)d,and duration intravenous antibiotic after operation(8.2±2.6)d.Compared with the Group B,intraoperative blood loss,duration of the use of painkiller postoperatively,duration of the use of hemostatic agents postoperatively,duration before recovery of intestinal function after operation,length of hospital stay after operation,and duration on intravenous antibiotic after operation in Group A were significantly lower than in Group B(p<0.05).There was no significant difference between the operation time,the time of catheterization,the incidence of postoperative complications,or the incidence ofbladder tumor and distant metastasis.Conclusions: Compared with traditional open nephroureterectomy,retroperitoneal laparoscopy combined with small abdominal incision for treatment of renal pelvis(ureter)carcinoma has advantages like less bleeding,smaller trauma,lesser complications,shorter length of hospital stay and faster postoperative rehabilitation.And it can thus be used as a safe and effective,viable minimally invasive surgery for the treatment of renal pelvis(ureter)carcinoma.