后腹腔镜分支肾动脉阻断肾部分切除术的临床分析(附13例报告)  

Clinical analysis of retroperitoneal laparoscopic partial nephrectomy with blockage of renal arterial branches(Report of 13 cases)

作　　者：王庆杰[1] 刘贵中[2] 孙光[1] 徐勇[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 [2]天津市津南区咸水沽医院泌尿外科

出　　处：《临床泌尿外科杂志》2014年第1期24-26,共3页Journal of Clinical Urology

摘　　要：目的：初步评估后腹腔镜分支肾动脉阻断肾部分切除术的可行性和安全性。方法：回顾性分析2011年2月～2013年2月对13例肾癌患者行后腹腔镜分支肾动脉阻断肾部分切除术的临床资料（肿瘤直径≤4．0cm）。观察手术时间、术中出血量、分支肾动脉阻断时间、术后住院时间和围手术期并发症。结果：全部患者手术均成功完成。手术时间120～170rain，平均135min；分支肾动脉阻断时间14～40min，平均26min；术中出血量50～190ml，平均95ml；术后住院时间8～10d，平均9d，围手术期无并发症。术后病理诊断：肾透明细胞癌10例，嫌色细胞癌2例，乳头状癌1例，肿瘤切缘均阴性。随访5～24个月，所有患者均未见肿瘤局部复发、转移。结论：后腹腔镜分支肾动脉阻断肾部分切除术术中出血少、损伤小，术后恢复快，并最大限度保留肾功能单位。初步观察该手术安全可行，是后腹腔镜下肾动脉主干阻断肾部分切除术与开放手术的有益补充。Objective： To assess preliminarily the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy with blockage of renal arterial branches. Method： Clinical data of 13 cases with renal cancer under- went retroperitoneal laparoscopic partial nephrectomy with blockage of renal arterial branches from Feb. 2011 to Feb. 2013 were retrospectively analyzed. The diameter of tumors were within 4.0 cm. Statistical data including operation time, intraoperative blood loss, renal arterial branches blockage duration, postoperative hospital stay and perioperative complications were observed. Result： Thirteen cases were completed successfully. The average operation time was 135 （range, 120-170） min. The average renal arterial branches blockage duration was 26 （range, 14-40） min. The average intraoperative blood loss was 95 （range, 50-190） ml. The average postoperative hospital stay was 9 （range, 8-10） d. There was no perioperative complications. Pathology indicated that clear cell carcinoma was seen in ten cases, chromophobe carcinoma was found in two cases and papillary carcinoma was dis- covered in one case. The surgical incisal margins were negative in all cases. During 5-24 months of follow-up peri- od, there was no recurrence and metastasis in all cases. Conclusion： The benefits of retroperitoneal laparoscopic partial nephrectomy with blockage of renal arterial branches include less blood loss, minimal damage, quick recov- ery, maximal preservation of the nephron and its function. The operation is safe and feasible based upon prelimina- ry study, which is likely to replace retroperitoneal laparoscopic partial nephrectomy with blockage of main renal ar- tery or open surgery.

关 键 词：肾癌 后腹腔镜手术 肾部分切除术 分支肾动脉阻断 

分 类 号：R737.11[医药卫生—肿瘤]