保留肾单位的肾癌手术(附65例报告)

目的:探讨保留肾单位的肾癌手术治疗方法和疗效。方法:65例行保留肾单位的肾癌切除手术,肿瘤直径(2.0～6.5)cm,平均3.9cm;肿瘤位于肾上极19例,肾中部16例,肾下极30例。TNM分期:T1a 42例,T1b 23例。透明细胞癌58例,颗粒细胞癌6例,乳头状肾细胞癌1例。结果:肾部分切除术65例,术中阻断肾蒂血管47例。所有病例手术切缘均为阴性。术后出现并发症5例,围手术期无患者出现急性肾功能衰竭。64例肾细胞癌患者获随访,平均随访时间61.4个月,5年生存率及5年无瘤生存率分别为98.4%和93.8%。结论:肾癌保留肾单位手术是治疗局限性肾癌的有效方法。

Nephron-sparing Surgery for Renal Cell Carcinoma

Objective:To investigate the method and efect of nephron-sparing surgery in treatment of renal cell carcinoma. Methods:NSS of RCC was performed in 65 patients.The mean tumor size was 3.9 am in diameterrange(2.0～6.5 )am].Nineteen tumors were at the upper pole of kidney?16 at the middle and 30 at the lowerpole.Fourty two cases were classified to have T1 stage tumor and 23 cases were T2 stage according to TNM classification.Pathological examination showed that 58 cases had clear cell carcinoma,6 had granule cell carcinoma,and one had papillary renal cell carcinoma.Results:Sixty five were treated with partial nephrectomy.The renal vessel was clamped in 47cases intraoperative.Surgical margins were negative in all cases.Five patients had postoperative complications and no perioperative acute renal failure occurred.Sixty four were followed for mean 61.4 months.The overall and disease-free 5-year survivalrates were 98.4%and 93.8%respectively.Conclusion:NSS is an efective and safe procedure for RCC patients under specific circumstances.