摘要
目的:探讨肾内生型复杂肾囊性病变行腹腔镜肾部分切除术(laparoscopic partial nephrectomy,LPN)的可行性和安全性。方法:回顾性分析我院2016年5月~2017年2月诊治的7例内生型复杂肾囊性病变患者的临床资料,所有患者均在腹腔镜超声(laparoscopic ultrasonography,LUS)协助下行LPN。男2例,女5例;年龄33~59岁,平均41.2岁;2例位于肾中部,2例位于肾上极,3例位于肾下极;囊肿直径2.5~3.5cm,平均2.9cm。Bosniak分型:Ⅱ型1例,ⅡF型3例,Ⅲ型2例,Ⅳ型1例。结果:本组7例患者均在LUS协助下成功进行LPN。手术时间65~110 min,平均72 min;术中出血量20~80 ml,平均42 ml;肾动脉阻断时间16~24min,平均19.2min。手术前后血肌酐无明显变化。术后病理结果肾透明细胞癌7例,所有切缘均阴性。结论:对于位于肾实质内部的内生型复杂肾囊肿,LUS可以协助手术医师行LPN,能完整切除肾实质内部的内生型复杂肾囊性病变,无论病理结果为良性还是恶性,均达到治疗目的。
Objective：To investigate the feasibility and safety of laparoscopic nephron sparing surgery for treatment of centrally located complex renal cystic lesions.Method：Seven cases of centrally located complex renal cystic lesions treated with laparoscopic nephron sparing surgery assisted with laparoscopic ultrasonography in our hospital were analyzed retrospectively from May 2016 to February 2017.There were 2 males and 5 females,aged from 33 to 59（mean,41.2）years old.The locations were 2 cases in the middle of the kidney,2 cases in the upper pole and 3 cases in the lower pole of the kidney.The diameter of the renal cyst was from 2.5 to 3.5（mean 2.9）cm.There were 1 case of typeⅡ,3 cases of typeⅡF,2 cases of typeⅢ and 1 case of typeⅣ according to the Bosniak classification.Result：Seven patients were performed laparoscopic nephron sparing surgery assisted with laparoscopic ultrasonography successfully.The operation time was from 65 to 110 min with an average of 72 min,and the intraoperative blood loss was from 20 to 80 ml,with an average of 42 ml.The renal artery occlusion time was from 16 to 24 min,with an average of 19.2 min,and there was no significant change in serum creatinine before and after operation.The pathological results were 7 cases of renal clear cell carcinoma with all negative margins.Conclusion：It is of high clinical value for laparoscopic ultrasonography in laparoscopic nephron sparing surgery for centrally located complex renal cystic lesions,and it help to determine the tumor location and guarantee negative margins.Laparoscopic nephron sparing surgery can resect the possible malignant renal cystic lesions completely no matter whether it is benign or malignant while preserving the kidney.
作者
董德鑫
刘广华
肖河
黄钟明
荣石
纪志刚
李汉忠
DONG Dexin;LIU Guanghua;XIAO He;HUANG Zhongming;RONG Shi;JI Zhigang;LI Hanzhong(Department of Urology, Peking Union Medical College Hospital, Beijing, 100730, China)
出处
《临床泌尿外科杂志》
2018年第5期404-406,共3页
Journal of Clinical Urology
关键词
复杂肾囊性病变
内生型
腹腔镜肾部分切除术
腹腔镜超声
切缘
complex cystic lesions
centrally located
laparoscopic partial nephrectomy
laparoscopic ultra-sonography
margin
