后腹腔镜手术结合靶向药物治疗同时性双侧多发肾癌的经验总结及文献回顾分析  

The experience of retroperitoneal laparoscopic surgery and targeted therapy for bilateral synchronous renal cell carcinoma and system review

作　　者：张克[1] 卢慕峻[1] 达骏[1] 徐明曦[1] 董国勤[1] 王忠[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院泌尿外科,200011

出　　处：《中华临床医师杂志（电子版）》2015年第2期22-25,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨双侧同时性多发肾癌的腹腔镜手术加靶向药物治疗疗效。方法对1例双侧肾透明细胞癌患者(右侧肿瘤8 cm,左侧肿瘤2枚,分别为4.5 cm和1 cm),先行后腹腔镜下左肾部分切除术,术后根据病理予舒尼替尼治疗4周,再行后腹腔镜下右侧肾癌根治术。结果手术均顺利完成,2次手术时间分别为100 min和110 min,第一次手术热缺血时间30 min。术后出现血肌酐一过性升高,达252μmol/L,后逐渐下降,随访6个月,恢复良好,血肌酐168μmol/L。结论双侧同时性肾癌较罕见,后腹腔镜手术切除安全有效且患者恢复快,采用分期手术对肾功能的恢复更有利,期间辅助使用靶向药物可抑制肿瘤发展。Objective To present the experience of retroperitoneal laparoscopic surgery for bilateral synchronous renal cell carcinoma. Methods A patient with bilateral synchronous renal cell carcinoma （tumor in right kidney is 8 cm, and tumors in left kidney are 4.5 cm and 1 cm） received unilateral retroperitoneal laparoscopic nephron-sparing surgery and treatment of sunitinib after the first operation. 4 weeks later, the patient underwent contralateral retroperitoneal laparoscopic radical nephrectomy. Results Retroperitoneal laparoscopic surgery was performed successfully without conversion to open surgery. Operative time was 100 minutes and 110 minutes, respectively. Blocking time of renal artery branch was 30 minutes in the first operation. The level of serum creatinine raised to 252μmol/L and decreased slowly to 168μmol/L after 6 months. Conclusion Bilateral synchronous renal cell carcinoma is very rare. Retroperitoneal laparoscopic surgery is safe, effective and feasible for this disease with faster recovery. Two-stage operation is more favorable for the recovery of renal function. And targeted therapy has satisfied efficacy in the period.

关 键 词：肾肿瘤 双侧 腹腔镜检查 

分 类 号：R737.11[医药卫生—肿瘤]