后腹腔镜保留肾单位手术治疗T_(1b)期肾癌的疗效观察  

Retroperitoneal laparoscopic nephron-sparing surgery in treatment for patients with T_(1b) renal cell carcinoma

作　　者：周海滨[1] 唐青[1] 廖鑫鑫[1] 黄玉清[1] 张良[1] 曾泉[1] 

机构地区：[1]九江学院附属医院泌尿外科,江西九江332000

出　　处：《临床泌尿外科杂志》2013年第11期816-818,共3页Journal of Clinical Urology

摘　　要：目的：探讨后腹腔镜保留肾单位手术（NSS）治疗Tlb期肾癌（RCC）的手术方法及临床疗效。方法：2009年2月-2012年2月，对5例临床分期为T1b期RCC患者行后腹腔镜NSS，其中男3例，女2例，平均年龄（55．4±9．6）岁，左侧3例，右侧2例。肿瘤平均直径（5．7±1．3）cm。结果：所有手术均顺利完成，无中转开放，围手术期无严重并发症。平均手术时间（110．0±29．5）min，术中平均热缺血时间（24．2±5．1）min，术中平均出血量（42．2±13．1）ml，术后尿漏1例；术后平均住院时间（5．9±2．1）d，术后平均随访（25．3±11．1）个月，全部患者。肾功能正常且未见肿瘤局部复发及远处转移。结论：后腹腔镜NSS治疗Tlb期RCC创伤小、出血少、并发症少且近期疗效满意；但其远期疗效还需大样本对照研究和长期随访观察。Objective： To study the operation method and clinical effect of retroperitoneal laparoscopic neph-ron-sparing surgery in treatment for patients with Tlb renal cell carcinoma （RCC）. Method： From February 2009 to February 2012, five patients （three males and two females） with Tlb RCC underwent retroperitoneal laparoscop-ic nephron-sparing surgery. Mean age was （55.4±9.6） years old, including three cases on the left side and two cases on the right side. The average diameter of the tumors was （5.7±1.3） era. Result： All the operations were accomplished successfully without conversion to open surgery and no serious complications occurred. The average operation time was （110.0±29.5） min, the mean warm ischemia time was （24.2±5.1） min, and the mean vol-ume of intraoperative bleeding was （42.2±13.1） ml. Urinary leakage was found in one case postoperatively. The average postoperative hospital stay was （5.9±2.1） d. All patients had normal renal function and had no tumor lo-cal recurrence and distant metastasis during a mean follow-up period of （25.3±11.1） months. Conclusion： Retro-peritoneal laparoscopic nephron-sparing surgery is a recommendable approach with minimally invasion, less bleed-ing, fewer complications. It＇s effective for the patients with TlbRCC. However, clinical controlled trials, observa-tional studies and long-term follow-up plan in large samples are needed.

关 键 词：肾癌 后腹腔镜 保留肾单位手术 

分 类 号：R737.11[医药卫生—肿瘤]