后腹腔镜肾部分切除术在治疗T1b期肾癌中的临床应用  

Retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal carcinoma

作　　者：林明恩[1] 姚友生[2] 刘皓[2] 张彩霞[2] 谢云[2] 

机构地区：[1]汕头大学医学院第一附属医院泌尿外科,515041 [2]中山大学孙逸仙纪念医院泌尿外科

出　　处：《中国医师进修杂志》2014年第14期11-13,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨后腹腔镜肾部分切除术治疗T1b期肾癌的临床疗效和安全性.方法 回顾性分析14例T1b期肾癌患者的临床资料,均行后腹腔镜肾部分切除术;其中男11例,女3例,年龄（54.5±9.2）岁.左侧8例,右侧6例.肿瘤直径（5.1±1.3） cm.结果 14例手术经后腹腔镜均顺利完成,无中转开腹手术.手术时间（112.0±24.7） min,术中出血量（64.6±15.9） ml,术中热缺血时间（26.5±9.3） min.14例患者术中、术后均未输血.术后负压引流管放置时间（3.1±1.5）d,术后卧床72 h.术后12h肌酐升高1例,余患者术后未发现明显并发症.术后病理：14例患者手术切缘均为阴性,其中透明细胞癌13例,病理分期均为T1bN0M0;肾血管平滑肌脂肪瘤1例.术后随访3 ～16（21.4±9.6）个月,未见肿瘤局部复发以及远处转移,未见切口肿瘤种植.结论 选择后腹腔镜下肾部分切除术治疗T1b期肾癌临床疗效确切,而且创伤小、恢复快,具有较好的临床应用前景.Objective To evaluate the clinical effect and safety of retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal carcinoma.Methods Fourteen patients （11 males and 3 females） with T1b renal carcinoma were retrospectively performed.The age of patients was （54.5 ± 9.2）years old,with 8 cases on the left side and 6 cases on the right side.Tumor diameter was （5.1±1.3） cm.All the patients received retroperitoneal laparoscopic partial nephrectomy.Results None of the 14 cases was converted to open surgery.The operation time was （112.0 ± 24.7） min,the intraoperative blood loss was （64.6 ± 15.9） ml,the warm ischemia time was （26.5 ± 9.3） min.The 14 patients were not blood transfusion in intraoperative and postoperative.Postoperative negative pressure drainage placement time was （3.1 ± 1.5）d,lying in bed time was 72 h.Serum creatinine increase was found in 1 case postoperative 12 h,others were no severe complications.Postoperative pathology：the incisal margin of 14 cases were all negative,clear cell carcinoma was in 13 cases,the pathology stage was T1bNoM0;angiomyolipoma of kidney was in 1 case.All the patients were follow-up 3-16 （21.4 ± 9.6） months,all the patients had normal renal function and had no tumor recurrence or metastasis.Conclusion Retroperitoneal laparoscopic partial nephrectomy is safe and reliable for treatment of patients with T1b renal carcinoma.

关 键 词：癌 肾细胞 后腹腔镜检查 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]