保留肾单位手术治疗肾错构瘤  

Nephron-sparing surgery for renal angiomyolipoma

作　　者：王平[1] 张志根[1] 郑丹叶[1] 唐爱娟[2] 唐桂良[2] 

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,杭州310000 [2]浙江绍兴市人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2003年第10期592-593,共2页Journal of Clinical Urology

摘　　要：目的 :探讨肾错构瘤 (RAML)行保留肾单位手术 (NSS)治疗的有效性 ,对术后肾功能保存及肿瘤复发情况进行评估。方法 :对 35例RAML行NSS治疗患者的临床资料进行分析。结果 :在有明显症状RAML 17例患者中 ,最常见的症状或体征是疼痛 (5 9% )、血尿 (41% )、腹膜后出血 (11% )、高血压 (18% )等。其中有 1例并发结节性硬化综合征。 2 8例患者有正常的对侧肾 (Ⅰ组 ) ,7例患者为功能性孤立肾 (Ⅱ组 ) ,平均随访时间 37(6～ 12 0 )个月。所有手术在原位完成 ,术中无并发症 ,平均失血量 4 0 0 (15 0～ 80 0 )ml。术后Ⅰ组、Ⅱ组平均肌酐分别为 83.98μmol/L和16 9.73μmol/L。随访期间无患者出现肿瘤复发及需要透析治疗。 结论 :当RAML需要外科手术时 ,NSS是一种高成功率的方式。Purpose:To evaluate the efficacy of nephron sparing surgery(NSS) in the management of RAML.Methods:The clinical symptom, surgical approach, and outcome of 35 patients who underwent NSS for treatment of RAML were analyzed.Results:The most common symptoms or signs were lumbag(59%), hematuria(41%), retroperitoneal hemorrhage(11%), hypertension(18%). One patient had tuberous sclerosis. Contralateral kidney of 28 patients were normal (groupⅠ), 7 patients had a solitary functioning kidney (groupⅡ). All operations were performed in situ, had no intraoperative complication, average blood loss volume was 400 ml. The media postoperative serum creatinine level in group Ⅰ and Ⅱ were 0.95 mg/dl and 1.92 mg/dl, respectively. The median follow-up period of all patients is 37 months (6～120 months), no patients had recurrent RAML or required dialysis.Conclusions:NSS is a good procedure for RAML when surgical management is demanded.

关 键 词：肾肿瘤 错构瘤 保留肾单位手术 

分 类 号：R730.265[医药卫生—肿瘤]