后腹腔镜技术联合肋缘下切口处理巨大肾肿瘤伴肾静脉癌栓的可行性及安全性研究  

Prospective study on the safety and efficacy of retroperitoneal laparoscopy combined with subcostal incision for the treatment of huge renal tumor with renal vein tumor thrombus

作　　者：应向荣[1] 沈冲[1] 

机构地区：[1]绍兴市人民医院泌尿外科,浙江绍兴312000

出　　处：《临床泌尿外科杂志》2015年第1期18-19,23,共3页Journal of Clinical Urology

摘　　要：目的：探讨后腹腔镜技术联合肋缘下切口处理巨大肾肿瘤伴肾静脉癌栓的可行性及安全性研究。方法：对24例巨大肾肿瘤伴肾静脉癌栓患者均采用在后腹腔镜的方式结扎并切断肾动脉,再取患侧肋缘下切口,切除癌栓及肾脏的方法进行治疗,观察患者术中及术后各项临床指标,术后随访患者复发情况。结果：本组平均手术时间105（95～165）min,术中出血量平均130（100～190）ml,术后平均排气时间8（6～12）h,平均住院时间10（8～12）d10术后随访24例,平均随访时间13（7～20）个月。7例分别于术后5、6、8、10、13、14、17个月时复发,转移至肺、肝及后腹膜等部位而死亡,其余未见肿瘤复发及转移等。结论：后腹腔镜技术联合肋缘下切口是治疗巨大肾肿瘤伴肾静脉癌栓安全有效的方法之一。Objective： To explore the feasibility and safety of retroperitoneal laparoscopic surgery plus subcos- tal incision in the treatment of large renal tumors with renal vein cancer embolus. Method： Twenty-four patients （11 males and 13 females） of large renal tumors with renal vein cancer embolus were removed kidney and cancer embolus with incision under costal margin after ligating and transecting renal artery in retroperitoneal laparoscopic operation. We observed the intraoperative and postoperative clinical data. Result： The average operation time was 105 （range, 95-165） rain, and the average intraoperative blood loss was 130 （range, 100-190） ml. The average a- nal exhaust time was 8 （range, 6-12） hours. The average hospital stay was 10 （range, 8-12） days. Over a mean follow-up period of 13 （range, 7-20） months, seven patients died of lung or liver metastasis at 5-17 months postoperatively. No recurrence or metastasis of tumors occurred in other patients. Conclusion： Retroperitoneal laparo- scopic surgery plus subcostal incision is feasible and safe for the patients with large renal tumors and renal vein cancer embolus.

关 键 词：肾肿瘤 肾静脉癌栓 后腹腔镜技术 肋缘下切口 

分 类 号：R737.11[医药卫生—肿瘤]