摘要
目的总结肾部分切除术治疗T1期肾癌的手术方式和临床疗效。方法回顾性分析20例行肾部分切除术的T1期肾癌患者的临床资料,男11例,女9例,平均年龄44岁。20例中双侧肾癌1例,孤立肾肾癌2例,对侧肾有病变或有潜在功能受损的肾癌6例,对侧肾功能正常的肾癌11例。肿瘤平均直径3.8cm。开放手术行肾部分切除术14例,后腹腔镜肾部分切除术6例,其中行选择性肾段动脉阻断的肾部分切除术2例。结果手术均顺利完成,平均出血80ml,平均手术时间160min。平均肾动脉及肾段动脉阻断时间28min。术后病理均为肾透明细胞癌。18例患者获访3～36个月,平均18个月,无外科并发症,无肿瘤局部复发及远处转移。术后出现暂时性肾功能不全2例,肾萎缩1例。结论肾部分切除术治疗早期肾癌安全有效,后腹腔镜肾部分切除术与开放手术比较,除术中出血稍多和手术时间稍长外,肿瘤的控制和并发症无显著差异。后腹腔镜选择性肾段动脉阻断的肾部分切除术在肾功能保留方面有一定优势。
Objective To summarize the surgical technique and therapeutic effect of partial nephrectomy for T1 stage renal tumor.Methods To retrospectively analyze the clinical data of 20 cases underwent partial nephrectomy for renal tumor,the study was comprised of 20 cases,11 cases were male and 9 cases were female,the average age was 44 years old.Among the 20 cases,1 case was bilateral kidney tumors,2 cases were tumors of solitary kidney,6 cases were disordered or with potentially impaired function at contralateral kidney,11 cases were with normal contralateral kidney,the average diameter of tumor masses was 3.8 cm.14 cases underwent open partial nephrectomy.6 cases underwent retroperitoneal laparoscopic partial nephrectomy,in which 2 cases were applied with selective blockage to renal segmentary artery.ResultsAll operations were completed successfully,the average blood loss was 80 ml,the average operative duration was 160 min,the average blockage duration of renal artery was 28 min.Post-operative pathology：all cases were renal clear cell carcinoma,18 cases were followed up from 3 to 36 months,the average duration was 18 months.The follow-up indicated there was no surgical complications,no local recurrence or distant metastasis,however,after operation,there was temperary renal dysfunction in 2 cases,renal atrophy in 1 case.ConclusionsPartial nephrectomy for early-stage renal tumor is safe and effective,compared to the open surgery,the retroperitoneal laparoscopic partial nephrectomy has not significant difference in terms of tumor control and complications except that the intra-operative blood loss is slightly more and operation duration is slightly longer than that of the open surgery.Retroperitoneal laparoscopic partial nephrectomy with selective blockage to renal segmentary artery has certain advantage in the respect of renal function preservation.
出处
《现代泌尿生殖肿瘤杂志》
2011年第2期89-91,共3页
Journal of Contemporary Urologic and Reproductive Oncology
关键词
肾肿瘤
外科手术
腹腔镜
Kidney neoplasms
Surgical procedures
Laparoscopes
