天津医药

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后腹腔镜肾部分切除术治疗T1b期肾癌17例报告

王庆杰1,刘贵中2,孙光1,徐勇1   

  1. 1. 天津医科大学第二医院
    2. 天津市津南区咸水沽医院
  • 收稿日期:2013-07-23 修回日期:2013-08-12 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 刘贵中

Retroperitoneal laparoscopic partial nephrectomy for T1b renal cell carcinoma：a report of 17 cases

  • Received:2013-07-23 Revised:2013-08-12 Published:2014-01-15 Online:2014-01-15

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摘要： 摘要 目的：探讨后腹腔镜肾部分切除术(RLPN)治疗T1b期肾癌的安全性和临床效果。方法：回顾性分析17例行RLPN的T1b期肾癌患者的临床资料。男11例，女6例；平均年龄55（48～67）岁；肿瘤最大径平均5.3（4.3～6.8）cm。观察手术时间、术中出血量、热缺血时间、术后住院天数等技术参数和术后肾功能变化。结果：16例手术均顺利完成，1例因术中切穿肾盂，解除阻断后出血不能控制，改行根治性肾切除术。手术时间平均125（105～175）min；热缺血时间平均27（18～39）min；术中出血平均125（70～330）ml；术后住院平均10（8～12）d。术后1例漏尿，1例肌酐短暂性升高。患者均康复出院。术后病理：肾透明细胞癌14例，嫌色细胞癌2例，乳头状癌1例。术后随访4～112个月，患者肾功能均正常且未见肿瘤局部复发、远处转移及切口种植等。结论：RLPN治疗T1b期肾癌安全可行，是T1b期肾癌患者的手术选择之一，但远期疗效仍需大样本对照研究和长期随访观察。

关键词: 肾肿瘤, 后腹腔镜手术, 肾部分切除术

Abstract: Abstract Objective：To investigate the safety and clinical effect of retroperitoneal laparoscopic partial nephrectomy(RLPN) for T1b renal cell carcinoma. Methods： Clinical data of 17(11 males，6 females，mean age 55（48～67）years) cases underwent RLPN for T1b renal cell carcinoma were analyzed retrospectively，and the mean tumor size was 5.3(4.3～6.8)cm. Surgical parameters(operation time，blood loss，warm ischemia time，postoperative stay time) and clinical outcomes were observed and analyzed. Results：Sixteen cases were completed successfully with only one case it converted to radical nephrectomy due to uncontrollable bleeding during operation. The average operation time was 125(105～175)min；the average warm ischemia time was 27(18～39)min；the average blood loss was 125(70～330)ml；the average postoperative stay time was 10(8～12)days. One patient had urine leakage and another had serum creatinine transient increase postoperation. All patients were very well recovered. Pathology indicated clear cell carcinoma in 14 cases，chromophobe carcinoma in 2 cases and papillary cell carcinoma in 1 case. During 4～112 months of following-up，all cases had normal renal function and had no recurrence of tumor，distant metastasis and transplant metastasis at Trocar wound. Conclusion：RLPN，which is safe and feasible，is one of operation choice for patients with T1b renal cell carcinoma，but its long-term effects still need large sample studies and long-term follow-up.

Key words: renal tumor, retroperitoneal laparoscopy, partial nephrectomy