肾肿瘤剜除术治疗肾细胞癌、肾血管平滑肌脂肪瘤

目的探讨肾肿瘤剜除术治疗肾细胞癌及肾血管平滑肌脂肪瘤的疗效。方法回顾分析15例在我院进行肾肿瘤剜除术的肾细胞癌及肾血管平滑肌脂肪瘤患者的临床及病理资料。结果全部肾肿瘤均成功剜除，平均热缺血时间为15min，术中肿瘤剜除面平均出血25ml，术后无继发出血，无急性肾小管坏死、慢性肾功能不全及尿瘘等并发症发生。术后平均随访时间为2．5年，均未见肿瘤复发或转移。依据2003AJCC肾癌分期方法，所有肾癌患者均为Tla期，组织学形态为透明细胞癌。病理分级按Fuhrman标准为G1。结论肾肿瘤剜除术对有假性包膜的Tla肾细胞癌和肾血管平滑肌脂肪瘤是有效和安全的，术后并发症少，可以最大程度地保留肾脏功能。

Simple enucleation for the treatment of renal cell carcinoma and renal angiomyolipoma

Objective To study the curative effect of simple enucleation for treating renal cell carcinoma(RCC)and renal angiomyolipoma(AML)in a series of patients treated in our department.Methods Clinical and pathological data of 15 patients with RCC and renal AML who underwent nephron sparing surgery by simple enucleation were retrospectively reviewed.Results Simple enucleation was successfully performed on all patients.The mean warm ischemic time was 15 min.The mean intraoperative blood loss from the field of enucleation was 25 ml,and none of the patients had postoperative bleeding requiring reintervention.There were no major complications,e.g.prolonged acute tubular necrosis,chronic renal insufficiency and urinary leakage.At a mean follow-up of 2.5 years,none of the patients had local tumor recurrence.Pathological review according to the 2003 AJCC classification showed there were 5 cases of RCCs in T1a.Histopathological review revealed they were clear cell RCCs.Based on Fuhrman nuclear grade,all of the tumors were in G1.Conclusion Simple tumor enucleation is a useful and acceptable approach to small,clinical T1a RCC and renal AML,and is not associated with increased risk of complications.It provides functional advantage by the maximal preservation of renal parenchyma.