腹腔镜下保留肾单位手术治疗肾肿瘤的疗效分析  

Clinical analysis of laparoscopic nephron sparing partial nephrectomy for treatment of renal tumor

作　　者：周逢海[1] 马玉磊[2] 王养民[1] 常德辉[1] 杨旭凯[1] 蓝天[1] 苗鹏程[1] 杨琦[1] 吕海迪 

机构地区：[1]兰州军区兰州总医院全军泌尿外科中心,甘肃兰州730050 [2]兰州大学第二临床医学院泌尿外科,甘肃兰州730000

出　　处：《中国内镜杂志》2014年第10期1051-1054,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜下保留肾单位的肾部分切除术治疗肾肿瘤的临床疗效与手术经验。方法回顾分析2011年1月-2013年8月在该科室行保留肾单位的肾肿瘤切除术治疗的86例肾T1期肿瘤患者的临床资料,其中腹腔镜组：男28例,女25例;年龄38-73岁,平均（53.9±8.9）岁,肿瘤直径1.3-4.5 cm,平均（3.3±0.8）cm;开放手术组：男19例,女14例;年龄39-68岁,平均（54.7±6.1）岁,肿瘤直径1.4-4.4 cm,平均（3.3±0.6）cm。结果 86例手术均获得成功,腹腔镜组手术时间85-150 min,平均（105±10.9）min,术中出血量30-100 mL,平均（51.6±14.5）mL,肾脏热缺血时间17-32 min,平均（22.6±3.8）min,住院天数6-14 d,平均（9.1±1.9）d;开放手术组手术时间60-130 min,平均（92.0±19.9）min,术中出血量50-130 mL,平均（75.0±19.3）mL,肾脏热缺血时间20-38 min,平均（31.0±4.7）min,住院天数7-16 d,平均（11.0±2.7）d。86例患者均无术后并发症发生,术后随访未见复发。结论腹腔镜下保留肾单位手术治疗肾肿瘤手术创伤小,术后恢复快,疗效确切,安全有效。【Objective】To discuss the clinical efficacy and surgical experience of laparoscopic nephron sparing partial nephrectomy for treatment of renal tumor. 【Methods】86 patients of T1 stage renal tumor who underwent nephron sparing partial nephrectomy from January 2011 to August 2013 were followed up. The clinical data of these patients were retrospectively analyzed. There were 28 male and 25 female in the group of laparoscopic, the age of patients was from 38 to 73 years（the mean was（53.9±8.9） years）. The diameter of tumors was from 1.3 to 4.5 cm（the mean was（3.3±0.8） cm）. There were 20 male and 14 female in the group of open surgery, the age of patients was from 39 to 68 years（the mean was（54.7±6.1） years）. The diameter of tumors was from 1.4 to 4.4 cm（the mean was（3.3±0.6） cm）.【Results】All the operations were accomplished successfully. The group of laparoscopic： the operation time was（105±10.9） min（85-150 min）. The volume of blood lose was（51.6±14.5） mL（30-100 mL）. Renal warm ischemia time was（31.0±4.7） min（20-38 min）. The average time of hospital stay was（9.1 ±1.9） d（6-14 d）.The group of open surgery： the operation time was（92.0±19.9） min（60-130 min）. The volume of blood lose was（75.0±19.3） mL（50-130 mL）. Renal warm ischemia time was（22.6±3.8） min（17-32 min）. The average time of hospital stay was（11.0±2.7） d（7-16 d）. All the patients had no postoperative complications. The follow-up indicated allthe patients were no recurrences. 【Conclusion】Laparoscopic nephron sparing partial nephrectomy is security and effective, the surgical trauma is small and the postoperative recover is quickly.

关 键 词：腹腔镜 保留肾单位手术 肾肿瘤 

分 类 号：R692.9[医药卫生—泌尿科学]