腹腔镜保留肾脏肾肿瘤切除术

目的:探讨腹腔镜保留肾脏手术治疗肾肿瘤的临床应用价值。方法:为21例患者施行腹腔镜保留肾脏肾肿瘤切除术,其中13例经后腹腔途径,8例经腹腔途径,肿瘤直径2.5～4.0cm。术后病理为15例肾脏透明细胞癌(T1N0M0),6例肾血管平滑肌脂肪瘤。结果:21例手术均获成功,手术时间80～130min,血管阻断时间10～35min,术中失血100～400ml,术后无出血、尿漏等重要并发症发生。术后短期随访所有透明细胞癌病例5～22个月无局部复发。结论:腹腔镜保留肾脏肾肿瘤切除术治疗早期肾脏肿瘤(直径≤4cm)安全有效,患者损伤小,康复快,值得临床推广应用。

Laparoscopic nephron-sparing surgery for renal tumor

Objective:To evaluate the clinical effect of laparoscopic nephron-sparing surgery for treatment of the renal tumor.Methods:Thirteen of twenty-one patients with renal tumor were treated with retroperitoneal laparoscopic nephron-sparing surgery,and the eight patients with laparoscopic nephron-sparing surgery.The mean tumor size in diameter was 2.5-4.0cm.Considering the postoperative pathology,fifteen were clear-cell cancinoma(T1N0M0),and six were angiomyolipoma of kidney.Results:All procedures were technically successful without conversion to open surgery in the twenty-one patients.The mean operative time was 80-130min and the time of the block of the blood vessel was 10-35min,and the blood loss in the operation was 100-400ml.No postoperative complication occurred such as haemorrhage or urinary fistula and so on.Neither local recurrence nor metastasis was observed during a follow up of 5-22 months.Conclusions:The laparoscopic nephron-sparing surgery is feasible and safe for the selective patients with early renal tumors(the diameter<4cm).This procedure has the advantages of precise and complete tumor excision,minimal invasion,less complications and shorter convalescence,and it is worth to extend in the clinic.