囊性肾癌的微创保肾手术难点及对策  

Dilemma and strategy of minimally invasive nephron-sparing surgery for cystic renal cell carcinoma

作　　者：潘秀武 叶剑青 曲发军 崔心刚 PAN Xiuwu;YE Jianqing;QU Fajun;CUI Xingang(Department of Urology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200092,China)

机构地区：[1]上海交通大学医学院附属新华医院泌尿外科,上海200092

出　　处：《临床泌尿外科杂志》2022年第9期688-692,共5页Journal of Clinical Urology

基　　金：上海市申康中心重大临床研究项目(No:SHDC2020CR4025)。

摘　　要：囊性肾癌是一类低度恶性潜能的复杂性肾肿瘤,约占肾脏肿瘤的4%。囊性肾癌的保肾手术挑战大,其囊壁薄,术中易破溃导致肿瘤细胞外溢可能,很难达到保肾手术的无瘤原则。本中心通过结合术前智能三维重建、解剖程序化操作、早期开放缝合技术等多种创新技术及方案,提高了囊性肾癌保肾手术的安全性和可行性。本文将从囊性肾癌的微创保肾手术角度,阐述囊性肾癌的术前评估、术中难点、术中技巧等方面,结合国内外文献及本中心诊疗经验进行深入探讨。Cystic renal cell carcinoma is a complex renal tumor with a low-grade malignancy potential,accounting for approximately 4% in all kidney tumors.Nephron-sparing surgery for cystic renal cell carcinoma is challenging.It is easy to rupture during surgery,leading to the possibility of tumor cell extravasation,because the cyst wall is thin.It is difficult to achieve the tumor-free principle of nephron-sparing surgery.Our center has improved the safety and feasibility of nephron-sparing surgery for cystic renal cell carcinoma by combining various innovative technologies and solutions such as preoperative intelligent 3 D reconstruction,anatomical procedure surgery,and early unclamping technology.From the perspective of minimally invasive nephron-sparing surgery for cystic renal cell carcinoma,this article describes the preoperative evaluation,intraoperative difficulties,and intraoperative skills of cystic renal cell carcinoma,and conducts in-depth discussions based on literature and our center’s experience.

关 键 词：囊性肾癌 保肾手术 手术策略 

分 类 号：R737.11[医药卫生—肿瘤]