后腹腔镜下保留肾单位与根治性肾切除术治疗T1bN0M0期肾癌的疗效比较  

Comparison of clinical efficacy between retroperitoneoscopic nephron sparing surgery and radical nephrectomy for treatment of 1bN0M0 renal cell carcinoma

作　　者：孙曙[1] 李州利[1] 蔡明[1] 李响[1] 王强[1] 陈昌庆[1] 李聪然[1] 石炳毅[1] 

机构地区：[1]解放军第309医院全军器官移植研究所泌尿外科,北京100091

出　　处：《解放军医学院学报》2015年第2期115-117,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的比较后腹腔镜下保留肾单位手术(retroperitoneoscopic nephron sparing surgery,RPNSS)与根治性肾切除术(retroperitoneoscopic radical nephrectomy,RPRN)治疗T1b N0M0期肾癌的临床疗效。方法回顾性分析2009年1月-2013年7月在我院行后腹腔镜下保留肾单位手术的T1b N0M0期肾癌16例及根治性肾切除术患者40例。比较两组手术时间、术中出血量、术后输血情况、术后并发症、引流时间、术后肌酐水平、局部复发及远处转移等指标。结果两组手术时间、术中出血量的差异有统计学意义(P<0.05)。在术后输血情况、引流时间、术后肌酐、局部复发及远处转移方面差异均无统计学意义(P>0.05)。结论腹腔镜下保留肾单位手术治疗T1b N0M0期肾癌疗效可靠,术后对患者的肾功能影响较小,与根治性肾切除术的局部复发及转移情况相似。Objective To compare the clinical efficacy on retroperitoneoscopic nephron sparing surgery （RPNSS） and retroperitoneoscopic radical nephrectomy （RPRN） for stage TIbNOM0 renal cell carcinoma （RCC）. Methods Clinical data about TlbNOM0 RCC patients who received RPNSS （n=16） and RPRN （n=40） in our hospital from January 2009 to July 2013 were retrospectively analyzed. The operative time, intraoperative blood loss, postoperative blood transfusion rate, postoperative complications, drainage days, long-term renal function, local recurrence and distant metastasis rates of the two groups were observed and compared. Results The difference of two groups was statistically significant in the operative time and intraoperative blood loss （P 〈 0.05）. However, no significant difference was found in postoperative blood transfusion rate, postoperative complications, drainage days, long-term renal function, local recurrence and distant metastasis rates. Conclusion As for patients with TlbNOM0 renal cell carcinoma, the clinical efficacy of RPNSS is reliable with less side effects on renal function in patients. Compared with RPRN, RPNSS has similar effects on long-term renal function, local recurrence and distant metastasis rates.

关 键 词：肾癌 腹腔镜 保留肾单位手术 根治性肾切除术 

分 类 号：R737.11[医药卫生—肿瘤]