摘要
目的观察保留肾单位手术治疗巨大肾错构瘤的疗效。方法收集2015年1月至2022年6月于新疆医科大学第一附属医院泌尿外科中心行保留肾单位手术的35例巨大肾错构瘤患者的临床资料,均在通过经腹途径开放手术或腹腔镜手术切除肿瘤的同时保留足够多的肾实质,对患者的手术疗效进行总结分析。结果35例手术均顺利完成,腹腔镜手术者无中转开放手术,无破裂出血。手术时间为65~265(139.82±54.94)min,出血量为20~1100(279.72±310.42)mL。22例开放手术冷缺血时间为15~65(36.43±13.92)min,13例腹腔镜手术热缺血时间为20~40(26.47±4.96)min。术后3~5 d内复查血肌酐为36~110(69.99±17.54)μmol/L。术后拔管时间为3~11(4.84±1.63)d,术后住院时间为4~12(6.71±1.73)d,术后有18例行肾脏发射计算机断层扫描(ECT)分肾功能检查,患侧肾脏肾小球滤过率(GFR)为28.7~57.6(37.38±8.15)mL·min^(-1)·(1.73 m^(2))-1。术后随访3~87(46.16±26.97)个月,肾功能均正常且未见肿瘤复发。结论保留肾单位手术治疗巨大肾错构瘤在技术成熟的医疗中心是安全可行的。
Objective To observe the therapeutic effect of nephron sparing surgery on giant renal hamartoma.Methods The clinical data of 35 patients with giant renal hamartoma who were admitted to the Urinary Surgery Center of the First Teaching Hospital of Xinjiang Medical University for nephron sparing surgery from January 2015 to June 2022 were collected.In all the cases,sufficient renal parenchyma was retained while the tumors were removed by transabdominal open surgery or laparoscopic resection,and the surgical effects of the patients were summarized and analyzed.Results All the operations were completed successfully in the 35 cases.In the patients undergoing laparoscopic resection,there were no cases of conversion to open surgery and no ruptured bleeding.The operation time was 65-265(139.82±54.94)minutes and the blood loss was 20-1100(279.72±310.42)millilitres.The cold ischemia time was 15-65(36.43±13.92)minutes in 22 cases of open surgery.The warm ischemia time was 20-40(26.47±4.96)minutes in 13 cases of laparoscopic surgery.The serum creatinine value was 36-110(69.99±17.54)μmol/L 3 to 5 days after surgery.The postoperative extubation time was 3-11(4.84±1.63)days,and the postoperative hospitalization time was 4-12(6.71±1.73)days.The renal emission computed tomography(ECT)score of bilateral renal function examination was performed in 18 cases after surgery.The glomerular filtration rate(GFR)of the affected kidneys was 28.7-57.6(37.38±8.15)mL·min^(-1)·(1.73 m^(2))-1,and during the follow-up of 3-87(46.16±26.97)months,their renal function was normal and no tumor recurrence was found.Conclusion Nephron sparing surgery is safe and feasible for treatment of giant renal hamartoma in technologically mature medical centers.
作者
侯亚坤
周星宇
拜合提亚·阿扎提
木拉提·热夏提
王玉杰
王文光
HOU Yakun;ZHOU Xingyu;Baihetiya·Azati;Mulati·Rexiati;WANG Yujie;WANG Wenguang(Urinary Surgery Center,the First Teaching Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中国临床新医学》
2024年第2期196-199,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
