后腹腔镜下保留肾单位手术治疗肾脏肿瘤的临床研究  

Clinical study of retroperitoneal laparoscopic nephron sparing surgery for the treatment of kidney neoplasm

作　　者：李超文[1] 黎承杨[1] 

机构地区：[1]广西医科大学第一附属医院泌尿外科,南宁市530021

出　　处：《微创医学》2015年第3期277-280,共4页Journal of Minimally Invasive Medicine

基　　金：广西自然科学基金(编号:2011GXNSFA018177)

摘　　要：目的 探讨后腹腔镜下行保留肾单位手术治疗肾脏肿瘤的手术效果.方法 对30例肾脏肿瘤患者行后腹腔镜下保留肾单位手术.其中右肾16例,左肾14例.结果 28例后腹腔镜下保留肾单位手术顺利完成.1例因肿瘤位置特殊,腹腔镜下缝合困难,中转为开放手术;1例为肿瘤侵犯集合系统,改为腹腔镜下肾癌根治术;手术时间60 ～ 345 min,平均154 min,肾动脉阳断时间20～50 min,平均26 min,术中出血0.030～0.400 L,平均0.104 L,围手术期无输血,术后无出血、尿瘘等并发症,病理检查切缘均阴性.术后住院时间5～17 d,平均9.6d.术后随访10～ 26个月,未见肿瘤复发.结论 后腹腔镜下保留肾单位手术治疗肾脏早期肿瘤,具有解剖清晰、创伤小、恢复快、并发症少等优点,值得有条件的单位推广应用。Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic nephron sparing surgery for kidney neoplasm. Methods 30 patients with kidney neoplasm underwent retroperitoneal laparo- scopie nephron sparing surgery. And there were 16 cases with right kidney neoplasm, 14 cases with left kidney neoplasm. Results The laparoscopic nephron sparing surgery was completed successfully in 28 cases. One case had difficulty with suture under laparoscopy and was converted to open surgery due to the special location of the tumor. And one case was converted to laparoscopic ntdical nephrectomy because the renal collection sys- tem was invaded by the tumor. The mean operative duration was 154 min [ range, （60 -345 ） mini. The mean warm isehemia time was 26 min [range, （20 -50） mini. The mean estimated blood loss was 0. 104 L [ range, （0.030 -0.400）L]. Perioperative transfusion was not conducted in any of cases. No post-operative complications of hemorrhage and urinary leakage occurred. Pathologic results revealed negative surgical mar- gins in all cases. The mean hospital stay after the surgery was 9.6 d [range, （5 - 17） d]. There were no tumor recurrences during the followed-up of 10 to 26 months. Conclusions Retroperitoneal laparoscopic nephron sparing surgery has various advantages for early-stage kidney neoplasm including clear operative field, faster recovery, less complication and less tissue trauma. And it is worthy of application and promotion in qualified hospitals.

关 键 词：后腹腔镜 肾肿瘤 保留肾单位手术 

分 类 号：R737.11[医药卫生—肿瘤]