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后腹腔镜下保留肾单位手术治疗T1期肾癌的临床体会(附37例报告)
引用本文:屈卫星,李晶,程永毅,徐永刚.后腹腔镜下保留肾单位手术治疗T1期肾癌的临床体会(附37例报告)[J].现代肿瘤医学,2014,0(10):2405-2407.
作者姓名:屈卫星  李晶  程永毅  徐永刚
作者单位:陕西省人民医院泌尿外科,陕西 西安 710068
摘    要:目的:探讨后腹腔镜保留肾单位手术(retroperitoneal laparoscopic partial nephrectomy,RLPN)治疗T1期肾癌的手术方法及临床效果。方法:回顾性分析37例行RLPN的T1期肾癌患者的临床资料,观察手术时间、术后住院时间、阻断方式及时间、术中出血和术后并发症及术后效果。结果:37例患者手术均顺利完成。手术时间62-185min,平均手术时间97min;肾动脉阻断时间0-47min,平均23.8min;出血量45-220ml,平均103.3ml;术中无并发症;术中切缘组织病理均阴性;术后无尿漏、继发出血及肾功不全发生;术后5天1例患者出现上消化道出血;平均住院日9天。随访时间3-48个月,平均24个月,复查B超及CT未见肿瘤复发及转移;复查静脉肾盂造影(IVP)提示患侧肾肾功能良好。结论:RLPN安全有效、创伤较小、出血少、恢复快,同时可保留患肾功能,可作为治疗T1期肾癌的首选手术方式。

关 键 词:肾癌  后腹腔镜  保留肾单位手术

Retroperitoneal laparoscopic partial nephrectomy for T1 renalcell carcinoma(report of 37 cases)
Qu Weixing,Li Jing,Cheng Yongyi,Xu Yonggang.Retroperitoneal laparoscopic partial nephrectomy for T1 renalcell carcinoma(report of 37 cases)[J].Journal of Modern Oncology,2014,0(10):2405-2407.
Authors:Qu Weixing  Li Jing  Cheng Yongyi  Xu Yonggang
Affiliation:Department of Urology,Shaanxi Provincial People's Hospital,Shaanxi Xi'an 710068,China.
Abstract:Objective:To evaluate the clinical experience of retroperitoneal laparoscopic partial nephrectomy ( RLPN)in the treatment of T1 renalcell carcinoma. Methods:RLPN was performed in 37 cases with T1 renalcell car-cinoma. Operation time,postoperative hospital staytime,the way and time of blocking,blood lose,postoperative compli-cations and effect were observed. Results:RLPN was performed in the 37 cases successfully. The meanoperation time was 97min(62-185min). The mean renal artery blood flow occlusiontime was 23. 8(0-47)min. The mean blood lose was 103. 3(45-220)ml. There was no intraoperative suigical complications. Intraoperative pathological margins were negative. There were no complications such as leakage of urine,secondary bleeding,renal insufficiency was oc-curred. 5 days after operation,1 patient had upper gastrointestinal bleeding. The mean hospital stay was 9d. During 24 (3-48)months of following up,there was no recurrence and metastasis,and no case was observed to have functional loss of the remaining kidney on intravenous urography. Conclusion:RLPN is safe,effective,mini-invasive,quicker recovery,meanwhile,renal function is maximally reserved,can be used as the preferred mode of operation treatment of stage T1 renal cell carcinoma.
Keywords:renal carcinoma  retroperitoneoscopic  nephron-sparing surgery
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