后腹腔镜肾部分切除术在治疗肾肿瘤的临床应用  

Extraperitoneal laparoscopic partial nephrectomy for renal tumor

作　　者：罗博[1] 赵小洲[1] 师彦平[1] 李小伟[1] 周菁[1] 

机构地区：[1]兰州大学附属天浩医院泌尿外科,兰州730060

出　　处：《中华腔镜泌尿外科杂志（电子版）》2010年第5期17-19,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨后腹腔镜保留肾单位的肾部分切除术治疗肾肿瘤的临床应用价值。方法 11例患者施行后腹腔镜保留肾单位的肾部分切除术的临床资料,其中男8例,女3例,年龄平均51.2岁,肿瘤直径3～4cm回顾性分析。结果所有手术均获成功,手术时间70～120min,血管阻断时间20～40min,术中失血100～300ml,术后无出血、尿漏等并发症。术后病理9例肾脏透明细胞癌(T1N0M0),2例肾血管平滑肌脂肪瘤,随访3～15个月无局部复发。结论后腹腔镜下保留肾单位的肾部分切除术治疗早期肾脏肿瘤,安全、有效,兼有创伤小,康复快等优点,近期疗效满意,远期疗效有待进一步观察。Objective To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic nephron-sparing partial nephrectomy for the treatment of renal tumors. Method 11 cases underwent retroperitoneal laparoscopic nephron-sparing partial nephrectomy . Tips and tricks： Exposured the tumor and the renal artery; Transient atraumatic clamping of the renal artery was done by bulldog or the silicone tube; Tumor excision with an approximate 1cm margin using ultrasound scalpel; The renal parenchyma suturings were combined with fibrin sealant and hemostatic gauze to stop the bleeding. Results All the procedures were technically successful without conversion to open surgery. The operative time was 70-120 min, warm ischemia time was 20-40 min, blood loss was 100-500 ml. No postoperative complication like bleeding or urinary leakage occurred. Postoperative pathology showed that 9 cases were renal clear cell carcinoma （T1N0M0）, and 2 cases were renal angiomyolipoma. With a follow-up of 3-15 months, no recurrence occurred. Conclusion Retroperitoneal laparoscopic nephron sparing partial nephrectomy which shows less trauma and quicker recovery is feasible and safe for early stage patients with renal tumors especially for the tumor less than 4 cm in diameter.

关 键 词：后腹腔镜 肾肿瘤 剜除术 

分 类 号：R737.11[医药卫生—肿瘤]