后腹腔镜下肾癌根治性切除术治疗肾癌65例分析报告  

Retroperitoneal laparoscopic radical nephrectomy in treatment of 65 cases of renal carcinoma

作　　者：姜刚刚 黄桂晓 张文娟 赵业娇 黄英 戴平 邹世敏 杨江根 JIANG Ganggang;HUANG Guixiao;ZHANG Wenjuan;ZHAO Yejiao;HUANG Ying;DAI Ping;ZOU Shimin;YANG Jianggen(Department of Urology,the Third Affiliated Hospital of Shenzhen University,Shenzhen 518000,Guangdong,China;Department of Neonatology,the Third Affiliated Hospital of Shenzhen University,Shenzhen 518000,Guangdong,China)

机构地区：[1]深圳大学第三附属医院泌尿外科,广东深圳5180000 [2]深圳大学第三附属医院新生儿科,广东深圳5180000

出　　处：《癌症进展》2021年第13期1356-1358,共3页Oncology Progress

摘　　要：目的探讨后腹腔镜肾癌根治性切除术在肾癌中的应用与疗效。方法分析65例行后腹腔镜下肾癌根治性切除术患者的病历资料,观察患者的临床治疗效果及并发症发生情况。结果 65例患者手术均成功,所有手术均在后腹腔镜下完成,没有中转开放;腹膜破裂2例,予以钛夹夹闭对症处理;无肠管及其他腹腔脏器损伤。所有患者手术切缘均为阴性,术后病理类型透明细胞癌55例,乳头状细胞癌6例,嫌色细胞癌3例,颗粒细胞癌1例。手术时间60~80 min,平均(70.00±4.55)min,术中出血50~80 ml,平均(68.00±3.25)ml,术后血红蛋白下降(24.52±10.55)g/L,无输血病例。所有患者均于术后1天下床活动,术后肛门排气时间为(2.00±0.66)天,术后肾床引流管拔除时间为(5.70±3.22)天,导尿管拔除时间为(4.70±1.22)天,术后出院时间为(5.88±2.32)天。随访1年,65例患者均无肿瘤复发及转移,无肾功能不全及肾衰竭。结论后腹腔镜下肾癌根治性切除术以其安全、创伤小、康复快等优点越来越受到各医院的青睐,值得临床推广。Objective To investigate the efficacy of retroperitoneal laparoscopic radical nephrectomy in the treatment of renal carcinoma.Method Clinical data of 65 cases of renal carcinoma treated with retroperitoneal laparoscopic radical nephrectomy was analyzed and the clinical efficacy and complications were observed.Result All the 65 patients were successfully operated under retroperitoneal laparoscopy without transferring to opening surgery.2 cases of peritoneal rupture were treated with titanium clip.There was no injury of intestine and other abdominal organs.The surgical margins were all negative with 55 cases of clear cell carcinoma,6 cases of papillary renal cell carcinoma,3 cases of chromophobe cell carcinoma and 1 case of granular cellcarcinoma by postoperative pathology.The operative time was 60-80 min,with an average of(70.00±4.55)min.Intraoperative bleeding was 50-80 ml,with an average of(68.00±3.25)ml.Postoperative hemoglobin decreased(24.52±10.55)g/L without case of transfusion.The average time to postoperative anal exhaust was(2.00±0.66)days,the time to ambulation was 1 day after surgery;the drainage tube of the kidney bed was removed(5.70±3.22)days after surgery,the catheter was removed(4.70±1.22)days after surgery,and the time to hospital discharge was(5.88±2.32)days after surgery.No tumor recurrence,metastasis,renal insufficiency or renal failure were observed in 65 patients after 1 year of follow up.Conclusion Retroperitoneal laparoscopic radical nephrectomy becomes more popular for its advantages of safety,less trauma and quick recovery,which is worthy of clinical promotion.

关 键 词：后腹腔 肾切除术 肾癌根治性切除术 肾蒂 

分 类 号：R737.11[医药卫生—肿瘤]