肿瘤吸除术治疗中央型肾错构瘤

目的探讨肿瘤吸除术治疗中央型肾错构瘤的手术技巧与临床疗效。方法采用肿瘤吸除术对6例中央型肾错构瘤实施肾错构瘤吸除术,其中行后腹腔镜肾错构瘤吸除术4例,开放性肾错构瘤吸除术2例。术中采用单纯阻断肾动脉并以吸引器吸除肿瘤的手术方式,观察手术时间、术中出血量、术后住院天数和术后并发症及手术效果。结果 6例手术全部获得成功。4例单纯性中央型肾错构瘤行后腹腔镜手术,平均手术时间为95min,平均出血量为83 m L,热缺血时间分别为15 min、18 min、23 min和24 min,术后住院时间均为4 d。2例合并肾结石的中央型肾错构瘤行开放手术,平均手术时间为115 min,平均出血量为190 m L,热缺血时间分别为19 min和22 min,术后住院时间均为6 d。所有手术效果好,无并发症,随访10个月,未见肿瘤复发和转移。结论肾错构瘤吸除术是一种安全、有效并可以广泛开展的手术方法,可为中央型肾错构瘤患者的治疗提供一种新的选择。

Tumor aspiration for central renal angiomyolipoma

Objective To discuss the technique of retroperitoneal laparoscopy aspiration and open surgery aspiration for central renal angiomyolipoma （CRAML） in six patients treated in our institution and to summarize our initial experiences. Methods The clini- cal data of six patients with pathologically confirmed central CRAML who underwent retroperitoneal laparoscopy aspiration for four pa- tients and open surgery aspiration for two patients were retrospectively reviewed. The renal artery was clamped with bulldog clamps with- out having the veins controlled. The operative time, blood loss, postoperative hospital stay, postoperative complications and operative effect were observed. Results All the procedures were successful without complication. To the retroperitoneal laparoscopy aspiration for CRAML： the mean operative time was 105 min, and the mean blood loss was 43 ml, and the warm ischemia time was 15 min, 18 min,23 min and the mean postoperative hospital stay was 4d. To the open surgery aspiration for CRAML： the mean operative time was 115 min, and the mean blood loss was 90 ml,and the warm ischemia time was 15 rain, 19 min,22 rain and the mean postoperative hospital stay was 6d. Follow - up period was 10 months and no tumor metastasized or occurred again. Conclusion Retroperitoneal laparoscopy aspiration and open surgery aspiration for CRAML is a recommendable method due to its safety and feasibility. It can be a nephron - sparing alterna- tive in CRAML patients.