保留肾单位的肾肿瘤切除术72例报告

目的:探讨保留肾单位的肾肿瘤手术方法和疗效。方法:回顾性分析72例经开放和腹腔镜行保留肾单位的肾肿瘤患者的临床资料。开放手术53侧,平均手术时间140min;腹腔镜手术23侧,平均手术时间200min。术中出血量100～1200ml。一侧有漏尿者行保守治疗。结果:肾良性肿瘤随访38例,平均随访8年,3例非肿瘤原位再发。肾癌随访15例,5年存活14例,无局部复发;10年存活11例,1例局部复发。结论:保留肾单位的肾肿瘤切除术安全有效,选择性肾动脉栓塞阻断血管最有效,腹腔镜下可以完成保留肾单位手术。

Nephron-sparing surgery(Report of 72 cases)

Objective:To investigate the surgical technique and therapeutic effect of nephron-sparing surgery for the treament of renal tumor.Methods:Clinical data of 72 patients with kidney neoplasms who received nephron-sparing surgery were reviewed retrospective.Results:Open surgery was performed on 53 kidneys(mean operation time 140 minutes). Laparoscopic surgery was performed on 23 kidneys(mean operation time 200 minutes). The volume of blood loss ranged 100 ml-200 ml. Leakage of urine happened in one patient and vanished after catheter drainage. Thirty eight patients with benign tumor were followed up for a mean time of 8 years,3 patients were noted having new tumor in a different place. Fifteen patients with renal carcinoma were followed up, 14 patients survived for 5years,none local recurrence noted, 11 patients survived for 10 years, one patient having tumor recurrence.Conclusions:Nephron-sparing surgery is safe and effective. Selective thrombosis of renal artery is the most effective method of blocking blood flow . Laparoscopic operation can execute nephron-sparing surgery.