后腹腔镜肾部分切除术治疗T_(1a)期肾细胞癌32例报告  

Retroperitoneal laparoscopic partial nephrectomy for T_(1a) renal cell carcinoma:a report of 32 cases

作　　者：王庆杰[1] 刘贵中[1] 王勇[1] 赵耀瑞[1] 

机构地区：[1]天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津300211

出　　处：《天津医科大学学报》2013年第6期484-486,共3页Journal of Tianjin Medical University

摘　　要：目的：评价后腹腔镜肾部分切除术（RLPN）治疗T1a期肾细胞癌的安全性和临床效果.方法：回顾性分析32例行后腹腔镜肾部分切除术的T1a期肾细胞癌患者的临床资料.观察手术时间、术中出血量、热缺血时间、术后住院天数.结果：31例手术均顺利完成,1例术中出血较多转开放性手术.手术时间90～155 min（平均115 min）;热缺血时间15～34 min（平均23 min）;术中出血40～280 mL（平均105 mL）;术后住院8～l0d（平均9d）.术后1例发生漏尿.患者均康复出院.术后病理：肾透明细胞癌24例,嫌色细胞癌6例,乳头状癌2例.随访3～79个月,患者均未见肿瘤局部复发、远处转移及切口种植等.结论：后腹腔镜肾部分切除术治疗T1a期肾细胞癌安全可行,是≤4.0cm的Tta期肾细胞癌的首选治疗术式,值得在具备条件的医院临床推广.Objective：To evaluate the safety and clinical effect of retroperitoneal laparoscopic partial nephrectomy （RLPN） for T1a renal cell carcinoma.Methods：Clinical data of 32 cases underwent RLPN for Tta renal cell carcinoma were analyzed.Operation time,blood loss,warm ischemia time,postoperative stay time were observed.Results：Thirty-one cases were completed successfully with only one case was converted to open surgery due to severe bleeding.The average operation time was 115 min （90～155 min）; the average warm ischemia time was 23 min （15～34 min）; the average blood loss was 105 mL （40～280 mL）; the average postoperative stay time was 9 days （8～10 d）.One patient had urine leakage postoperation.All patients were very well recovered.Pathology indicated clear cell carcinoma in 24 cases,chromophobe carcinoma in 6 cases and papillary cell carcinoma in 2 cases.The follow-up time was 3～79 months.Imaging examinations revealed no recurrence of tumor,distant metastasis and transplant metastasis at the Trocar wound.Conclusion：RLPN is safe and feasible for T1a renal cell carcinoma,and is the best choice for Tta renal cell smaller than 4.0 cm.

关 键 词：肾肿瘤 后腹腔镜手术 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]