摘要
尽管腹腔镜保留肾单位手术(NSS)已成为治疗T1a期肾肿瘤的标准术式,但对于孤立肾肾肿瘤、大体积肾肿瘤、中央型和肾门肿瘤、双侧和多发肾肿瘤等较复杂病变经腹腔镜手术处理的难度较大,这时开放性NSS仍是重要选择。根据患者实际情况和术者经验,开放性NSS可以经腹腔和腹膜后两种途径来完成。术中解剖要清晰、操作要细致,通过全身肝素化、肾动静脉全阻断和冰屑冷却肾脏低温处理等综合措施,努力实现肾功能损伤最小、肿瘤切缘阴性和并发症最少的NSS三大关键目标。
Although laparoscopic nephron sparing surgery （NSS） has become the standard surgical modality for renal corti‐cal tumors of T1a stage ,it is difficult to deal with complex renal tumors ,such as solitary kidney tumors ,larger tumors ,centrally located or hilar tumors ,bilateral or multifocal tumors .In these cases ,open NSS is still the optimal choice .In principle ,open NSS has two approaches ,transperitoneal and retroperitoneal ,which can be selected according to the actual condition of pa‐tients and experience of the surgeons .Comprehensive measures should be taken ,including systemic heparinization ,block of re‐nal arteries and veins ,ice cooling to treat kidney in low temperature ,to minimize damage on renal functions ,to obtain nega‐tive surgical margin ,and to reduce perioperative complications .
出处
《现代泌尿外科杂志》
CAS
2015年第3期141-143,共3页
Journal of Modern Urology
关键词
肾肿瘤
保留肾单位
开放手术
并发症
renal tumor
complex
nephron sparing surgery
open surgery
complications
