肾细胞癌保留肾实质手术的临床探讨  

Nephron-sparing Surgery in Renal Cell Carcinoma

作　　者：黄红卫[1] 葛根[1] 潘正跃[1] 习小庆[1] 刘芳明[1] 

机构地区：[1]江西医学院第二附属医院,330006

出　　处：《实用癌症杂志》2003年第5期517-518,共2页The Practical Journal of Cancer

摘　　要：目的　探讨保存肾实质手术在肾细胞癌治疗中的临床价值。方法　 1995年 2月～ 2 0 0 2年 12月 ,对 14例肾细胞癌病人施行保留肾实质手术 ,其中双侧肾癌 3例 ,对侧肾有病变或潜在功能受损的肾癌 5例 ,对侧肾功能正常的肾癌 6例。肿瘤直径2 .0～ 5 .8cm ,平均 3 .9cm。病理分期 :T1期 8例、T2 期 6例。 9例行肾部分切除术 ,5例行肿瘤剜出术。结果　本组 14例术后无并发症 ,随访 13例 ,6个月～ 7年 10个月 ,平均为 5 0个月 ,1例术后 3年发现肺转移 ,12例无瘤生存 ,本组均无肿瘤局部复发。 1例失访。结论　根治性肾切除术是肾癌手术的金标准 ,而保留肾实质的手术一般只用于双侧肾癌及解剖或功能上的孤立肾肾癌患者。近年来 ,随着医学影像学的不断发展、外科技术的日益提高以及偶发肾癌病例的增加 ,选择保留肾实质的手术也日渐增多。保留肾实质手术是治疗局限性肾细胞癌患者的有效手段 ,能安全有效地保存肾功能 。Objective To elucidate the value of nephron-sparing sugery in renal cell carcinoma.Methods From February,1995 to December,2002,nephron-sparing sugery was performed on 14 patients with renal cell carcinoma.Of which,there were 3 patients with bilateral tumors,5 patients with unilateral tumor and a damaged opposite kidney,and 6 patients with unilateral tumor and a nomal opposite kidney.The size of the tumors was 2.0～5.8 cm in diameter with an average of 3.9 cm.All the tumors were proved to be in stage T 1(8 cases)?T 2 (6 cases).Of the 14 patients,9 underwent partial nephrectomy,5 underwent tumor enucleation.Results There was no postoperative complication.13 patients were followed up with a mean follow-up period of 50 months.12 patients have been tumor-free suvived,No local recurrence was observed but metastasis occurred in one patient.Conclusion Nephron-sparing sugery is effective and safe for patients with localized renal cell carcinoma in low stage.It can also preserve the normal renal fuction.The effect of nephron-sparing sugery is similar to that of radical nephrectomy.

关 键 词：肾细胞癌 保留肾实质手术 肾动脉造影 CT 

分 类 号：R737.11[医药卫生—肿瘤]