目的:评价后腹腔镜肾部分切除术两种不同缝合方式的安全性及预后。方法:回顾性分析314例行后腹腔镜肾部分切除术的患者资料。术中行单层8字间断缝合肾脏创面者136例,分层缝合法修补肾脏组织缺损者178例。比较两组患者临床基本资料,肿瘤特性,围手术期预后以及术后肾功能差异。结果:术后8字缝合组和分层缝合组中位随访时间分别为34个月和30个月。两组在患者年龄(P=0.064),体质指数(P=0.611),手术时间(P=0.196),术中出血量(P=0.824),术中(P=0.655)和术后并发症(P=0.135)方面没有统计学差异。分层缝合组的肿瘤直径较8字缝合组大(3.4∶2.6cm,P=0.008)。两组在肿瘤位置(P=0.396)和切缘距离(P=0.070)之间没有差异。分层缝合患者在热缺血时间(18∶20 min,P=0.021),引流管留置时间(3.7∶4.3d,P=0.022)和住院时间(5.8∶6.2d,P=0.037)方面优于8字缝合患者。两组之间肌酐(sCr)的术前术后变化差异无统计学意义(P=0.797)。评估术前术后肾小球率过滤(eGFR),分层缝合组eGFR降低程度低于8字缝合组(6.7∶8.9ml·min-1·1.73m-2),差异有统计学意义(P=0.045)。结论:分层缝合法修补肾脏创面在后腹腔镜肾部分切除术中是安全有效的。改进的腔镜下缝合技术较腔内打结技术更易掌握,并且可以有效地缩短热缺血时间,从而减少手术对肾功能的影响。 Objective: To evaluate the safety and prognosis of retroperitoneal nephrectomy with two different sutures. Methods: A retrospective analysis of 314 cases of patients underwent laparoscopic partial nephrectomy data. During the operation, 136 cases were sutured with single-layer 8-word sutured kidney wounds and 178 cases were repaired by stratified suture. The basic clinical data, tumor characteristics, perioperative prognosis and postoperative renal function were compared between the two groups. Results: The median follow-up time was 34 months and 30 months in the 8-suture group and stratified suture group respectively. The patients were divided into two groups according to their ages (P = 0.064), body mass index (P = 0.611), operation time (P = 0.196), intraoperative blood loss (P = 0.824), intraoperative (P = 0.655) and postoperative complications P = 0.135) there was no statistical difference. Stratified suture group tumor diameter larger than the 8-suture group (3.4: 2.6cm, P = 0.008). There was no difference between the tumor location (P = 0.396) and the margin distance (P = 0.070). The stratified suture patients were superior to those of warm ischemia (18:20 min, P = 0.021), drainage tube indwelling time (3.7: 4.3 days, P = 0.022) and length of stay (5.8: 6.2 days, P = 0.037) 8 words suture patients. There was no significant difference in preoperative and postoperative changes of creatinine (sCr) between the two groups (P = 0.797). The preoperative and postoperative glomerular filtration rate (eGFR) was assessed. The reduction of eGFR in stratified suture group was lower than that in 8-suture group (6.7: 8.9 ml · min-1 · 1.73 m-2) (P = 0.045). Conclusion: The method of stratified suture to repair the kidney wound is safe and effective in retroperitoneoscopic partial nephrectomy. The improved endoscopic stitching technique is easier to grasp than the intracaval knotting technique and can shorten the warm ischemia time effectively and thus reduce the impact of surgery on renal function.