| Objective:To evaluate the clinical efficacy of laparoscopic and open surgery in the treatment of localized renal cell carcinoma by comparing the operation time,intraoperative hemorrhage,total cost of hospitalization,cost of each component,perioperative and long-term complications and survival period.Methods:a case-control study was used in this study to analyze retrospectively 162 cases of renal cancer confirmed by operation and postoperative examination in our hospital from January 2014 to June 2019,excluding patients who were transferred from laparoscopy to laparotomy,with other tumors or other major diseases,and who could not obtain follow-up information 42 patients(laparoscopic group)and 106 patients(open group)underwent laparoscopic renal cancer surgery.According to the condition of sex,age,pathological type of renal cell carcinoma and TNM grade,42 pairs of patients were selected.The operation time,intraoperative hemorrhage,postoperative hospitalization time,postoperative gastrointestinal ventilation time,total hospitalization cost and its components,perioperative and long-term complications were compared between the two groups.The measurement data of patients' age,tumor size,operation time,intraoperative blood loss and postoperative hospital stay were expressed as mean ± standard deviation,and were compared by independent sample t-test or nonparametric test(rank sum test)according to whether they conform to the normal distribution.?2 test or Fisher's exact probability method were used to compare the two groups of counting data,such as patients' gender,smoking,preoperative complications,tumor side,TNM stage(tumour nodes metastasis classification)and Fuhrman grade.At the same time,follow-up(up to December 30,2019)showed that there was no recurrence survival time between the two groups.Through Kaplan Meier survival analysis,the clinical outcomes of laparoscopic surgery and open surgery were compared.Results:1.There was no significant statistical difference in general information of the two groups,such as:gender,age,tumor size,tumor side,preoperative complications,smoking,pathological type,etc.2.There was no significant difference in operative time and postoperative hospital stay between the two groups,but there was significant difference in intraoperative hemorrhage and postoperative gastrointestinal ventilation time between the two groups.3.There was no significant difference in the long-term complications between the two groups.Kaplan Meier survival analysis between the two groups showed no significant difference.4.There was no significant difference in the total cost of hospitalization,examination cost and other costs between the two groups;there was significant difference in the operation and anesthesia cost,material cost and drug cost.Conclusions:1.The results of this study show that the incidence of complications in laparoscopic renal cancer surgery is less than that in traditional open surgery,with less bleeding and fast recovery of gastrointestinal tract.There was no significant difference in operation time,hospital stay,long-term complications and long-term survival between the two groups.2.There was no significant difference in the total cost,examination cost and other costs between the two methods of operation;the cost of laparoscopic operation,anesthesia and materials was higher than that of open operation;the cost of drugs for open operation was higher than that of laparoscopic operation.3.In the surgical treatment of localized renal cancer,laparoscopic surgery is superior to traditional open surgery in the comprehensive effect of perioperative period.Although there are differences in the cost,there is no significant difference in the total cost;the two surgical methods have no significant impact on the overall survival and survival rate of patients.Laparoscopic surgery is an effective operation for localized renal cancer. |
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