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| Efficacy and Renal Function Effect of Laparoscopic Nephron-sparing Surgery for Early Stage Renal Cell Carcinoma |
| ZHANG Ying, MA Bing, WANG Lin-lin |
| Shandong Provincial Third Hospital, operating room 250000 |
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Abstract 【Objective】To investigate the efficacy of laparoscopic nephron-sparing surgery(NSS) for early stage renal cell carcinoma and its effect on renal function. 【Methods】 The clinical data of 65 patients with early(T1a) renal cell carcinoma treated in our hospital were retrospectively analyzed. According to the different treatment methods, they were divided into a control group(n=29) and an observation group(n=36). The control group underwent radical nephrectomy(RN), and the observation group underwent NSS. The evaluation of operation procedure was compared between the two groups. Hemoglobin(Hb), urinary creatinine(Cr), urea nitrogen(BUN), and urinary cystatin C(urine Cys C) were detected in the two groups. Stress response indicators, including C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), cortisol(Cor) and angiopoietin-Ⅱ(Ang Ⅱ) differences across the two groups, were analyzed. Quality of life(SF-36 scale), recurrence and survival after 1 year of follow-up were compared between the two groups. 【Results】(1)Compared to the control group, the operation time of the observation group was significantly shortened, and the intraoperative blood loss was significantly reduced(P<0.05). There was no significant difference between the two groups in drainage, bedtime and hospital stay(P>0.05).(2) Compared to the control group, the Hb of the observation group was significantly higher, and the Cr, BUN and urinary Cys C were significantly lower(P<0.05).(3) One day after operation, CRP, TNF-α and Cor were higher than those before operation, and the control group was higher than the observation group(P<0.05). The AngII levels of the two groups were lower after the operation than those before operation, and that of the observation group was lower than that of the control group(P<0.05).(4) One year after operation, the SF-36 scores of the two groups were significantly higher than those before the operation, and those of the observation group was significantly higher than those of the control group(P<0.05).(5) After 1 year of follow-up, the imaging examination of the two groups showed no recurrence and distant metastasis; the survival rate of the control group was 93.10%(27/29) and the survival rate of the observation group was 94.44%(34/36). There was no significant difference in the 1-year survival rate between the two groups(P>0.05). 【Conclusion】 Compared to RN, NSS is reliable and has little effect on renal function, effectively reducing intraoperative stress response and improving postoperative quality of life.
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Received: 05 July 2019
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2021, Vol. 38 
