保留肾单位手术治疗肾肿瘤临床效果观察

目的探讨肾癌保留肾单位手术的治疗效果。方法 85例行保留肾单位的肾癌切除手术,肿瘤直径1.5～5.6 cm,平均3.4 cm;肿瘤位于肾上极37例、中极33例、下极15例。所有病例TNM分期均为T1N0M0。透明细胞癌54例,颗粒细胞癌21例,乳头状肾细胞癌7例,嫌色细胞癌3例。结果 85例均成功手术,随访78例,随访时间10～55个月,平均随访时间26个月,2例术后20个月出现同侧肾上腺肿瘤转移,行肾上腺切除术。余76例均未发现肿瘤局部复发和远处转移迹象。结论保留肾单位手术是治疗肾肿瘤安全有效,可在不降低生存率的前提下保留患肾功能,其临床应用越来越广。

Nephron sparing surgery for renal cell carcinoma

Objective To investigate the clinical effects of nephron sparing surgery(NSS) in renal cell carcinoma(RCC).Methods NSS of RCC was performed in 85 patients.The mean tumor size was 3.4cm in diameter(range 1.5 cm～5.6 cm).37 tumors were at the upper pole of kidney,33 at the middle and 15 at the lower pole.All cases were classified to have T1N0M0 stage tumor according to TNM classification.Pathological examination showed that 54 cases had clear cell carcinoma,21 had granule cell carcinoma,7 had cystic renal cell carcinoma,and.Chromophobe cell carcinoma.Results The operation was performed successfully in 85 patients.102 patients were followed-up for 26 months(range 10～55 months).The follow-up showed that no tumor recurrence in 76 patients was found and two patient was found adrenal cancer metastasis.Conclusion NSS is an effective and safe procedure for RCC patients under specific circumstances,providing functional advantage gained by the maximal preservation of unaffected renal parenchyma without sacrificing cancer control.