摘要
目的:探讨腹腔镜下保留肾单位肾部分切除术(LNSS)治疗肾肿瘤的可行性和疗效.方法:2010年3月～2012年3月行LNSS 73例,肿瘤直径1.5～6.0cm,平均4.3 cm.术前诊断错构瘤12例,肾癌61例(临床分期T1a期55例,T1b期6例).肿瘤位于左侧41例,右侧32例.肿瘤位于肾上极23例,肾下极19例,中部31例;肿瘤位于背外侧54例,腹侧19例,其中靠近肾门6例.合并高血压病17例,糖尿病9例,对侧肾结石5例,对侧肾萎缩1例,孤立肾1例.结果:手术均获成功,手术时间平均65 min,术中出血平均30 ml,热缺血时间平均24 min.切除范围据肿瘤边缘正常肾脏组织0.5 cm.7例术中发现集合系统损伤并行修补.术后病理提示错构瘤12例,透明细胞癌55例,嫌色细胞癌4例,乳头状细胞癌2例.术后病理切缘均阴性.术后腹膜后引流管留置7～9 d,导尿管留置5～7 d.1例术后继发性出血,给予高选择性肾动脉栓塞治疗.术后随访6～12个月,1例肺部转移,给予舒尼替尼靶向治疗,其余患者肿瘤无复发.结论:LNSS治疗直径小于7 cm肾肿瘤安全有效.
Objective:To evaluate the feasibility and efficacy of laparoscopic nephron-sparing surgery(LNSS)in treating renal tumor.Methods:We retrospectively analysed clinical data of 73patients given LNSS between Mar 2010and Mar 2012.Of the 73cases,49were males,24females.The diameter of tumor was between 1.5to 6.0centimeter,the mean was 4.3centimeter.Results:All surgeries were successfully taken.The mean last time was 65minutes.The mean amount of bleeding was 30ml during the surgery.The mean warm ischemia time was 24minutes.Resection range extented to 0.5cm outside the border of tumor.Collection system damage was found in 7patients and given repair.Pathological diagnosis showed angioleiomyolipoma in 12patients,clear cell carcinoma in 55,chromophobe cell tumor in 4,papillary carcinoma in 2.All the pathological of the border of the tumor were negative.After surgery,the lasting time of retroperitoneal drainage tube was 7-9days,and the catheter was 5-7days.One patient had secondary bleeding after surgery and was given selective renal artery embolization.During 612months follow-up,one patient had lung metastases and was given targeted therapy with sunitinib,no other patients had recurrence.Conclusions:LNSS was safe and effective in treating renal tumor with diameter less than 7cm.
出处
《微创泌尿外科杂志》
2013年第3期169-170,共2页
Journal of Minimally Invasive Urology
关键词
肾肿瘤
腹腔镜术
肾部分切除术
renal tumor
laparoscopy
nephron-sparing surgery
