摘要
目的探讨R.E.N.A.L.肾肿瘤评分系统对于双侧肾癌患者手术方式选择、手术风险预测的临床意义。方法回顾性分析我院泌尿外科2013年2月至2017年8月收治的7例双侧肾癌患者(14侧例)的临床资料,并进行R.E.N.A.L.系统评分,统计分析R.E.N.A.L.肾肿瘤评分与手术方式选择、肾脏热缺血时间、术中出血量、术后住院天数、围手术期并发症及术后肾功能等的关系。结果 14例次手术中,腹腔镜保留肾单位手术(LPN)10例次,腹腔镜肾根治性切除术(LRN)4例次;R.E.N.A.L.肾肿瘤评分系统低、中、高度复杂肿瘤分别为6例次、6例次、2例次,行LPN分别为6例次、4例次、0例次;R.E.N.A.L.评分均值LPN组(5.8±1.9)和LRN组(8.1±1.7)比较,差异有统计学意义(P<0.05);R.E.N.A.L.肾肿瘤评分系统与LPN方法的选择有显著相关性(χ2=30.9,P<0.05),低度及大部分中度复杂肿瘤适合行LPN。结论 R.E.N.A.L.肾肿瘤评分系统能够对双侧肾癌患者的手术方式选择、手术难易程度及手术风险进行较好评估。
Objective To discuss the clinical significance of R.E.N.A.L.kidney neoplasms marking system for the patients with bilateral kidney cancers.Methods We selected 7 patients(14 side cases)with bilateral kidney cancers received and cured by the first affiliated hospital of Zhengzhou University from Feb.2013 to Aug.2017,and a retrospective analysis was conducted,then R.E.N.A.L.system was used to evaluate,and we analyzed the relationship between the R.E.N.A.L.kidney neoplasms marking and selection of operation mode,warm-ischemia time,preoperative bleeding,length of stay after operation,complications in perioperative period and postoperative renal function.Results Ten cases were treated with laparoscopic partial nephrectomy(LPN).Other 4 cases underwent laparoscopic radical nephrectomy(LRN),and 6 cases,6 cases and 2 cases of low-,middle-,and highly-complex tumors in the R.E.N.A.L.kidney tumor scoring system.The LPNs were 6 cases,4 cases and 0 case respectively.The mean value of R.E.N.A.L.scores in LPN group(5.8±1.9)and LRN group(8.1±1.7)was statistically significant(P<0.05).The correlation between selection of R.E.N.A.L.renal tumor scoring system and LPN method was significant(χ^2=30.9,P<0.05).It showed that low and most moderately complex tumors were suitable for LPN.Conclusions R.E.N.A.L.nephrometry score is a comprehensive scoring system to evaluate the anatomical characteristics of kidney neoplasms,which can conduct relatively good evaluation for the selection of operation mode,complexity of operation and surgical risk of patients with bilateral kidney cancers.
作者
高震飞
孟庆军
高康
闫泽晨
高瞻
崔林刚
田雨冬
苏杨
徐鹏超
郭培超
GAO Zhen-fei;MENG Qing-jun;GAO Kang;YAN Ze-chen;GAO Zhan;Cui Lin-gang;TIAN Yu-dong;SU Yang;XU Peng-chao;GUO Pei-chao(Department of Urology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《现代泌尿生殖肿瘤杂志》
2018年第6期325-327,331,共4页
Journal of Contemporary Urologic and Reproductive Oncology
