偶发性肾癌保留肾单位手术的临床疗效观察(附16例报告)  

Clinical effect of nephron-sparing surgery for incidental renal cell carcinomas in 16 cases

作　　者：邓大溢 陈士洲 林长丰[1] 庞工占 方强[1] 

机构地区：[1]淮南市朝阳医院泌尿外科,232007

出　　处：《安徽医学》2011年第8期1134-1136,共3页Anhui Medical Journal

摘　　要：目的评价保留肾单位手术(NSS)治疗偶发性肾细胞癌的临床效果。方法回顾性分析16例偶发性肾癌施行NSS治疗的患者临床资料。临床分期均为T1N0M0期。11例行术中低温下肾动脉阻断,平均阻断时间11 min(6～20 min),5例未阻断肾动脉。手术切缘距肿瘤1.0 cm。术后均注射IFN-α及IL-2进行免疫治疗。结果 16例手术均顺利完成,16例肿瘤切缘均阴性;术中平均出血180ml(80～300 m1)。平均随访28个月(6～72个月)。术后继发性血尿3例,1例出现远处转移,随访期内无死亡病例。结论在适应证选择合适情况下,保留肾单位手术治疗偶发性肾癌是安全有效的,手术并发症发生率较低,且保留患肾部分功能。Objective To evaluate the clinical effect of nephron sparing surgery（NSS） for incidental renal cell carcinomas.Methods A retrospective analysis was performed for 16 patients who were affected by incidental renal cell carcinoma and treated with NSS.The clinical stage was T1N0M0 in all patients.The renal arteries were blocked for 11 patients,the mean intraoperative renal interrupted time was 11 min（range 6 to 20 min）.The mean size of surgical margin was 1.0cm.After operation all patients were treated with interferon alfa and interleukin-2.Results The procedure was successful in all 16 patients,and surgical margin were negative in all cases,The mean blood loss was 180ml（80～300 m1）.All patients were followed up for an average of 28 months（6 to 72 months）.The postoperative complications included urinary fistulas（3 cases）.One patient had developed distant progression.There was no death in this series of patients.Conclusion NSS is a safe and effective method to treat carefully selected incidental RCC patients.NSS can achieve a low local recurrence rate and can provid functional advantage by the maximal preservation of unaffected renal parenchyma1.

关 键 词：肾细胞癌 保留肾单位手术 治疗 

分 类 号：R737.11[医药卫生—肿瘤]