保留肾单位的肾癌手术（附66例报告）  

Nephron -sparing Sursery for Renal Cell Carcinoma

作　　者：李保军[1] 吴宏飞[1] 周鹤同[1] 于洪波[1] 张斌[1] 沈华[1] 李久明[1] 

机构地区：[1]南京明基总医院泌尿外科南京医科大学附属医院,江苏210019

出　　处：《国际泌尿系统杂志》2011年第3期278-282,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨保留肾单位的肾癌手术治疗方法和疗效。方法66例行保留肾单位的肾癌切除手术，肿瘤直径2．0～6．5cm，平均4．1cm；肿瘤位于肾上极19例，肾中部17例，肾下极30例。TNM分期：TlaNOM042例，T1bNOM023例，T3NOM01例。透明细胞癌59例，颗粒细胞癌6例，乳头状肾细胞癌1例。结果肾部分切除术66例，术中阻断肾蒂血管48例。所有病例手术切缘均为阴性。术后出现并发症5例，围手术期有一例患者出现急性肾功能衰竭。65例肾细胞癌患者获随访，平均随访时间61．4个月，5年生存率及5年无瘤生存率分别为98．5％和93．8％结论肾癌保留肾单位手术是治疗局限性肾癌的有效方法。Objectives To investigate the method and effect of nephron - sparing surgery in treatment of renal cell carcinoma. Methods NSS of RCC was performed in 66 patients. The mean tumor size was 4.1 cm in diameter（ range 2.0 -6.5 em）. Nineteen tumors were at the upper pole of kidney, 17 at the middle and 30 at the lowerpole. Fourty two cases were classified to have T1ANOM0 stage tumor and 23 cases were TI bNOMO stage,one case was T3NOMO stage according to TNM classification. Pathological examination showed that 59 cases had clear cell careinoma,6 had granule cell carcinoma,and one had papillary renal cell carcinoma. Results Sixty six were treated with partial nephrectomy. The renal vessel was clamped in 48 cases intraoperative. Surgical margins were negative in all cases. Five patients had postoperative complications and one perioperative acute renal failure occurred. Sixty five were followed for mean 61.4 months. The overall and disease - free 5 - year survivalrates were 98.5% and 93.8% Respectively. Conclusions NSS is an effective and safe procedure for RCC patients under specific circumstances.

关 键 词：肾肿瘤 肾单位 

分 类 号：R737.11[医药卫生—肿瘤]