马蹄肾肾细胞癌手术方式的选择并文献复习(附5例报告)  

Surgical treatment for renal cell carcinoma in horseshoe kidney and literature review:a report of 5 cases

作　　者：王光春[1] 彭波[1] 刘敏[1] 黄建华[1] 张海民[1] 鄢阳[1] 车建平[1] 许云飞[1] 罗明[1] 杨斌[1] 叶林[1] 姚旭东[1] 郑军华[1] 

机构地区：[1]同济大学附属第十人民医院泌尿外科,上海200072

出　　处：《上海医学》2015年第7期579-582,共4页Shanghai Medical Journal

摘　　要：目的探讨马蹄肾肾细胞癌(以下简称肾癌)的安全治疗方法。方法回顾性分析在同济大学附属第十人民医院接受治疗的5例马蹄肾肾癌患者的临床资料,肿瘤位于右侧肾脏1例、左侧肾脏4例,其中有2例患者的肿瘤累及峡部。总结各例患者的临床表现、诊断和治疗方法。结果5例患者经增强CT和增强MRI检查均获得及时准确的诊断,均行手术治疗。其中2例行后腹腔镜下根治性肾切除术,3例行经腹腔根治性肾切除术,均获得满意的疗效。结论根治性肾切除术是马蹄肾肾癌的首选治疗方案,血管解剖变异的术前评估和术中峡部处理是手术成功的关键,位于肾脏中上极、较小、肾动脉分支不多的肿瘤也可行后腹腔镜下根治性肾切除术。Objective To explore a safe treatment for renal cell carcinoma in patients with horseshoe kidneys. Methods Clinical data of 5 renal cell carcinoma patients with horseshoe kidneys treated in our hospital were retrospectively analyzed. The right kidney was involved in one patients and the left was involved in 4 patients. Tumors invaded the isthmus in 2 patients. Clinical manifestation, diagnosis and treatment of the five patients were analyzed. Results The five patients were correctly diagnosed and surgically treated in time. Two patients received retroperitoneal laparoscopic radical nephrectomy and three underwent transperitoneal radical nephrectomy. Satisfactory clinical outcomes were obtained in all patients. Conclusion Radical nephrectomy is an optimal treatment for renal cell carcinoma in horseshoe kidney. Preoperative evaluation of vascular malformation and minimally-invasive dissection of the isthmus are keys for surgical treatment. Retroperitoneal laparoscopic radical nephrectomy may be a good choice for patients with small tumors in the upper and middle pole of the kidneys.

关 键 词：马蹄肾 肾细胞癌 治疗 

分 类 号：R737.11[医药卫生—肿瘤]