腹腔镜下肾部分切除术治疗T1a期肾细胞癌83例分析

目的探讨T1a期肾细胞癌行腹腔镜下肾部分切除术的可行性及临床疗效。方法选择83例民期肾细胞癌患者行腹腔镜下肾部分切除术。肾动脉阻断，距肿瘤约0．5cm处，整块剪除肿瘤和部分肾实质及其表面的脂肪组织，分层缝合集合系统和肾实质，解除肾动脉阻断。观察手术时间、肾动脉阻断时间、术中出血量、术后并发症、肾功能、临床复发及转移情况。结果83例患者中2例因术中出血中转开放手术，其他病例均顺利完成腹腔镜手术。手术时间90～120min，平均105rain；热缺血时间25～40min，平均30min；术中出血40～120ml，均未输血。随访10～36个月，平均23个月，无继发出血，无漏尿，无肿瘤局部复发及远处转移，肾功能无异常。结论腹腔镜下肾部分切除术治疗T1a期肾细胞癌安全可行。

Laparoscopic partial nephrectomy treatment of 83 cases with T1a renal cell carcinoma

Objective To investigate the feasibility and clinical efficacy of laparoscopic partial nephrectomy for T1a renal cell carcinoma. Methods 83 cases of T1a renal cell carcinoma underwent laparoscopic partial nephrectomy. Renal artery occlusion, lifting from the tumor about 0.5 cm block cut off the fatty tissue of the tumor and part of the renal paren- chyma its surface, layered suture collection system and renal parenchyma, renal artery occlusion. The operation time, blood loss, postoperative complications, renal function, clinical relapse and metastasis of renal artery occlusion were ob- served. Results Among the 83 cases, laparascopic operation was successfully performed in 81 cases except 2 cases, which were converted to open surgery due to blood loss during the lapaparscopie operation. The mean operation time was 105 min （range, 90- 120 min） and the mean warm isehemia time was 30 rain （range, 25 -40 min）. The blood loss was 40 -120 ml, no blood transfusion. An average of 23 months of follow- up （range, 10 -36 months） showed no sec- ondary bleeding, no leakage of urine, no local tumor recurrence and distant metastasis, and no abnormal renal function. Conclusion Laparoseopie partial nephrectomy surgery for T1a renal cell carcinoma is feasible and safe.