马蹄肾并发肾细胞癌3例报告并文献复习  

Renal cell carcinoma in horseshoe kidney (Report of three cases and literature review)

作　　者：韩苏军[1] 王栋[1] 寿建忠[1] 李长岭[1] 

机构地区：[1]中国医学科学院肿瘤医院泌尿外科,北京100021

出　　处：《临床泌尿外科杂志》2016年第3期220-222,共3页Journal of Clinical Urology

摘　　要：目的：探讨马蹄肾并发肾细胞癌的诊断与治疗。方法：报告3例马蹄肾合并肾细胞癌的诊治过程及随访结果,并复习相关文献。结果：3例患者均为体检发现,无临床症状。所有患者均接受经腹膜后途径开放外科手术,2例行保留肾单位手术,1例行峡部离断并根治性肾切除术。术后病理均为透明细胞癌,切缘阴性。pT1期2例,pT2期1例。术后平均随访30（16~50）个月,未见肿瘤复发或远处转移。结论：对于符台手术条件的马蹄肾合并肾细胞癌患者,首选手术治疗,并应争取行保留肾单位手术。术前充分的影像评估有助于外科制定外科手术计划。术中仔细辨别所有动脉血管,以及妥善处理峡部是手术成功的关键所在。Objective：To investigate the diagnosis and treatment of renal cell carcinoma in horseshoe kidney.Method：The diagnosis,treatment and follow-up results of three patients with renal cell carcinoma in horseshoe kidney were retrospectively analyzed and related literature was reviewed.Result：All of the three patients presented with an asymptomatic renal mass in horseshoe kidney which was found incidentally in a comprehensive medical examination.All of these patients were successfully treated with open surgical procedures through the retroperitoneal approach including two nephron sparing surgeries and one radical nephrectomy with isthmus division.Pathologic examination revealed renal cell cancer,clear cell subtype and negative surgical margin.This series included two pT1 and one pT2 tumours.Neither recurrence nor metastases of the renal cell cancer was found over a mean follow-up period of 30（range,16-50）months..Conclusion：Nephron sparing surgery should be the preferred approach to proper cases of renal cell carcinoma in horseshoe kidney.Appropriate preoperative imaging may aid surgical planning.The key of surgical treatment lies in identification of all arterial branches and careful isthmus dissection.

关 键 词：马蹄肾 肾肿瘤 诊断 治疗 

分 类 号：R692.1[医药卫生—泌尿科学]