期刊文献+

保留肾单位手术与根治性肾切除术治疗T1a期肾癌疗效比较 被引量:14

Comparison of curative effect of radical nephrectomy and nephron sparing surgery for T1a renal carcinoma
下载PDF
导出
摘要 目的比较根治性肾切除术和保留肾单位手术两种术式治疗T1a肾癌的远期疗效。方法 T1a期肾癌病人共78例,40例为根治性肾切除术组,38例为保留肾单位手术组,通过比较两组患者住院时间、出血量、手术时间术中及术后并发症、5年生存率来评估手术期间以及手术前后肾功能、术后并发症、复发情况及5a生存率差异。结果 78例手术顺利。保留肾单位手术组和根治性肾切除术组平均手术时间分别为(95.8±14.6)min和(90.1±10.5)min;术后平均住院天数分别为(17.2±7.0)d和(15.5±10.1)d;术中失血量分别为(124.4±34.7)mL和(114.5±26.3)mL;术前肌酐分别为(82.3±13.5)μmol/L和(85.7±17.6)μmol/L,术后24h肌酐分别为(90.4±37.5)μmol/L和(105.8±46.7)μmol/L,术后5a肌酐水平分别为(86.6±28.3)μmol/L和(142.2±42.7)μmol/L;78例随访(52.7±8.7)个月,保留肾单位组5a生存率97.5%,肿瘤复发率2.5%;根治性肾切除术组5a生存率为97.4%,肿瘤复发率2.6%。两组平均手术时间、术中失血量、术后平均住院天数、肿瘤复发率、5a生存率差异均无统计学意义(P>0.05)。保留肾单位手术组术前,术后24h及术后5a3次肌酐值比较差异无统计学意义(P>0.05)。根治性肾切除术(RN)组术前,术后24h及术后5a3次肌酐值比较差异有统计学意义(P<0.05)。结论与肾癌根治术治疗T1a期肾细胞癌相比较,保留肾单位手术具有安全、局部复发率低、更好地保留功能性肾单位等优点,两种术式远期临床效果无明显差异。 Objective To compare the long-term effect of nephron-sparing surgery (NSS) and radical ne- phrectomy (RN) on Tla renal cell carcinoma. Methods A retrospective analysis of 38 Tla cases of NSS,RN in patients with clinical data of 40 Tla patients. The patients were divided into radical group and NSS group based on surgical approach. The duration of operation, hospital days, blood loss, postoperativecomplications, local recurrence and 5 year survival rate were recorded and analyzed. Results Seventy eight were with smooth operation. The mean duration of operation for NSS group and RN group were (95.8± 14.6) minutes and (90.1±10.5) minutes; the average postoperative hospitalization were (17.2±7.0) d and (15.5±10.1) d; blood loss were (124.4±34.7) mL and (114.5±26.3) mL; and the average preop erative SCr were (82.3±13.5) μmol/L and (85.7±17.6) μmol/L, and the average postoperative 24 hours SCr were (90.4±37.5) μmol/L and (105.8±46.7) μmol/L, and the average postoperative 5 years SCr were (86.6±28.3) μmol/L and (142.2±42.7) μmol/L All patients were successfully followed up for (52.7±-8. 7) μmol/L,. In NSS group, five-year survival rate was 97.5% and five-year tumor recurrencerate was 2.5%. In RN group, five-year survival rate was 97.4% and five-year tumor recurrence rate was 2.6%. There was no significant differences for the mean duration of operation, the average hospitaliza-tion, blood loss, five-year survival rate and five-year tumor recurrence rate between two teams (P〉0. 05). It had no differences (P〉0.05) for the average preoperative SCr, postoperative 24 hours SCr andpostoperative 5 years SCr in NSS group. There were obviously differences (P 〈0.05) for the average pre-operative SCr, postoperative 24 hours SCr and postoperative 5 years SCr in RN group. Conclusion Com-pare with RN, NSS surgery for Tla renal cell carcinoma is a safe, effective, with lower local recurrence rate, better retention of the functional advantages of renal units.
作者 张涛 王玉杰
出处 《新疆医科大学学报》 CAS 2012年第5期634-637,641,共5页 Journal of Xinjiang Medical University
基金 国家自然科学基金项目(81060210)
关键词 肾肿瘤 保留肾单位手术 根治性肾切除术 kidney neoplasms nephron sparing surgery radical nephrectomy
  • 相关文献

参考文献9

  • 1胡汪,洪宝发,朱捷,高江平,张磊.小肾癌54例诊治分析[J].现代泌尿外科杂志,2006,11(2):94-95. 被引量:6
  • 2Touijer K, Jacqmin D, Kavoussi LR, et al. The expanding role of partial nephrectomy: Scritical analysis of indications, re- sults,and complications[J]. Eur Urol, 2010,57 : 214-222.
  • 3Crepel M,Jeldres C, Perrotte P, et al. Nephron-sparing sergery is equally effective to radical nephrectomy for TlbNOM0 renal cell carcinoma: a population-based assessment[J]. Urology, 2010,75 (2) : 271-275.
  • 4Rozanee JJ, Ameri C, Hoist P, et al. Nephron-sparing surgery our experience ill open and laparoscopic approach in 254 cases [J]. Arch Esp Urol,2010,63(1) :62-69.
  • 5Van-Poppel H, Da Pozzo L, Albrecht W, et al. A prospective randomized EORTC intergroup phase 3 study comparing the cgmparing the complications of elective nephron-sparing surgery and radical nephrectomy for low-stage rena1 cell carcinoma [J]. Urol Oncol,2008,26(1):101-102.
  • 6Simon J,Finter F, Ignatius A, et al. Maximum tensile force of different suture techniques in reconstruction of the renal rem- nant after nephron-sparing surgery[J]. Surg Endosc, 2011,25 (2) : 503-507.
  • 7Fergany AF, Hafez KS, Novick AC. Long-term results of neph- ron sparing surgery for localizedrenal cell carcinoma: 10-year followupEJ]. J Urol, 2000,163 : 442-445.
  • 8Adkins KL,Chang SS,Cookson MS,et al. Partial nephrectomy safely preserves renal function in patients with a solitary kindey[J]. J Urol,2003,169(1) :79-81.
  • 9Mc-Kierman J, Simmons R, Katz J, et al. Natural history of chronic renal insufficiency after partial and radical nephrecto- my[J]. Urology,2002,59(6) :816-820.

二级参考文献9

共引文献5

同被引文献88

  • 1傅光华,赖建平,陈善勤,文小平.经腹膜后腹腔镜单纯性肾切除术的临床应用(附11例报告)[J].中国内镜杂志,2007,13(1):79-80. 被引量:3
  • 2张旭,李宏召.腹腔镜下保留肾单位手术治疗肾肿瘤现状[J].中华泌尿外科杂志,2007,28(7):437-438. 被引量:36
  • 3张滨,尚存海,于明川,李海波,常玉莲,樊文鑫,那彦群.螺旋CT肾脏灌注参数与肾功能生化检测指标的相关性研究[J].中华泌尿外科杂志,2007,28(9):592-595. 被引量:10
  • 4Paul JF, Ugolini P, Sapoval M, et al. Unilateral renal artery stenosis : perfusion patterns with electron-beam dynamic CT-preliminary expe- rience. Radiology ,2001,221:261.
  • 5Al-Said J,Kamel O. Changes in renal cortical and medullary perfu- sion in a patient with renal vein thrombosis. Saudi J Kidney Dis Transpl,2010,21 : 123.
  • 6Yilmaz O, Ovali GY, Genc A, et al. Perfusion computed tomography could be a new tool for single-session imaging of ureteric obstructive pathology: an experimental study in rats. J Pediatr Surg, 2009,44: 1977.
  • 7Miles KA. Measurement of tissue perfusion by dynamic computed tomography. Br J Radiol, 1991,64:409.
  • 8Miles KA. Perfusion CT for the assessment of tumour vascularity: which protocol? Br J Radiol,2003 ,76 :36.
  • 9Kandel S, Kloeters C, Meyer H, et al. Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial re- suits. Eur Radiol,2009 ,19 :2641.
  • 10Miles KA, Hayball MP, Dixon AK. Functional imaging of changes in human intrarenal perfusion using quantitative dynamic computed tomography. Invest Radiol, 1994,29:911.

引证文献14

二级引证文献37

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部