后腹腔镜下肾癌根治术的疗效分析及术后不同剂量IL-2免疫治疗中的疗效评价  

Evaluation of therapeutic efficiency of laparoscopic radical nephrectomy and postoperative immunotherapy with different doses of IL-2

作　　者：潘彩明[1] 黄后宝[1] 邱成[1] 

机构地区：[1]皖南医学院弋矶山医院泌尿外科

出　　处：《中国临床药理学与治疗学》2014年第8期926-930,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的：探讨后腹腔镜下肾癌根治术的临床疗效与体会及术后不同剂量IL-2免疫治疗的效果评价。方法：回顾分析38例肾癌患者，均采用后腹腔镜肾癌根治术，其中，透明细胞癌33例，乳头状肾细胞癌2例，颗粒色细胞癌3例。观察手术时间、术中出血量、术后胃肠道功能恢复时间、拔除引流管时间、术后平均住院时间及并发症。术后分组给予IL-218mLU／m2及1mLU／m2进行生物免疫治疗，并进行疗效评价及进行不良反应的比较。结果：38例患者，均获成功。手术时间60～180min，平均（80±20）min。术中出血30～100mL，平均（50±10）mL。术后1～3d胃肠道功能恢复，平均（1．0±0．3）d。术后2～5d拔除引流管，平均（3．0±0．2）d。术后平均住院时间5～8d，平均（6．0±0．5）d，术后无继发出血及切口感染。术后经病理证实为肾细胞癌。术后随访3～48月，平均（24±4）月，两组不同剂量IL-2免疫治疗患者在局部复发、远处转移、死亡及完全缓解等疗效分析上无明显差异，而在治疗期间不良反应上存在统计学差异。结论：后腹腔镜下肾癌根治术安全、有效且并发症少，术后结合生物免疫制剂治疗，可有效延缓肾癌复发及远处转移，且小剂量的IL-2也能达到大剂量的治疗效果。ABSTRACT AIM： To evaluate the therapeutic efficiency of laparoscopic radical nephrectomy and postoperative imrnunotherapy with different doses of IL-2. METHODS： A total of 38 patients underwent laparoscopic radical nephrectomy were enrolled. There were 33 patients with clear cell carcinoma, 2 patients with papillary renal cell carcinoma and 3 patients with granular cell carcinoma. Operative time, intraoperative bleed- ing, recovery time of gastrointestinal function, remove time of drainage tube, average hospital stay after operation and postoperative complica- tions were investigated. All patients were divid- ed into two groups according to postoperative irnrnunotherapy with different doses of IL-2： group 1 （18 rnL U/m2） and group 2 （1 mL U/ rn2）. The therapeutic efficiency and the adverse reactions between groups were also been com- pared. RESULTS： A total of 38 patients under- went laparoscopic radical nephrectomy were en- rolled. There were 33 patients with clear cell carcinoma, 2 patients with papillary renal cell carcinoma and 3 patients with granular cell carci-noma. Operative time, intraoperative bleeding, recovery time of gastrointestinal function, re- move time of drainage tube, average hospital stay after operation and postoperative complica- tions were investigated. All patients were divid- ed into two groups according to postoperative immunotherapy with different doses of IL-2. group 1 （18 mL U/m2） and group 2 （1 mL U/ m2）. The therapeutic efficiency and the adverse reactions between groups were also been com- pared. CONCLUSION. Laparoscopic radical ne- phrectomy is safe, effective and fewer complica- tions. Postoperative IL-2 immunotherapy can ef- fectively delay recurrence and distant metastasis of renal cell carcinoma. The therapeutic efficien- cy of postoperative immunotherapy with low- dose trial of IL-2 is similar to high-dose trial of IL-2.

关 键 词：肾癌 腹腔镜手术 腹膜后途径 根治性 肾切除术 白介素-2 

分 类 号：R73[医药卫生—肿瘤]