后腹腔镜根治性肾切除术治疗局限性肾癌

目的总结后腹腔镜根治性肾切除术治疗局限性肾癌的经验。方法2003年10月至2007年10月共对67例局限性肾癌患者施行后腹腔镜下根治性肾切除术，区域性淋巴结清扫，其中男44例，女23例；年龄25～78岁，平均年龄50．3岁。术后定期行血生化及影像学随访。结果本组手术平均时间176min，术中平均出血量70ml，术后平均住院时间8．5d。术中腹膜损伤2例，胸膜损伤1例，下腔静脉属支损伤2例，无一例中转开放手术。随访3～51个月。3年癌症相关生存率为96．4％。结论掌握术中常见并发症预防和处理方法、减少术中周围组织损伤是后腹腔镜肾癌根治术达到“微创”目标的关键。

Clinical experience with retroperitoneoscopic radical nephrectomy in treating localized renal cell carcinoma

Objective To summarize our experiences of retroperitoneoscopic radical nephrectomy in treating localized renal cell carcinoma. Methods Between October 2003 to October 2007 , retroperitoneoscopic radical nephrectomy and regional lymph nade sissecfion were performed on 67 patients with localized renal cell carcinoma. 44 patients were male and 23 were female, the mean age was 50.3 years （range 25 to 78 years）. Results The mean operative time was 176 min, the mean blood loss was 70 ml, and the mean postoperative stay was 8.5 days. The operative complications were peritoneal trauma （2 case）, pleura trauma （ 1 case） and the branch of inferior vena cava injury （2 case）. No one need to transfer to open surgery. Two cases died from distant metastasis during 3 - 51 months of followup. Three years of survival rate related to cancer is 96.4%. Conclusions Improving the techniques to reduce the complications of retroperitoneoscopic radical nephrectomy, mastering the methods to prevent complications, is the key to realize the objective of mini-invasion.