后腹腔镜保留肾单位肾脏肿瘤切除术（附15例报告）

目的探讨后腹腔镜行保留肾单位。肾脏肿瘤切除术的手术可行性及疗效。方法2007年3月至2008年8月，15例肾脏局限性肿瘤患者采用后腹腔镜保留肾单位肾脏肿瘤切除术。术中用bull-dog血管钳阻断肾脏血流，用超声刀在距离肿瘤边缘2～10mm处进行切除，肿瘤床随机切取三处组织送冰冻病理检查。结果15例手术均顺利完成，无一例中转开放。平均手术时间110min，术中平均阻断肾血流时间26min，术中平均出血量200ml，平均术后住院时间9d。术中切缘组织病理切片均为阴性。术后随访2～14个月肿瘤无复发。结论后腹腔镜保留肾单位肾脏肿瘤切除术治疗肾脏肿瘤技术可行，安全有效，其远期疗效尚有待长期随访。

Retroperitoneal laparoscopic nephron-sparing surgery for renal tumor : report of 15 cases

Objective To valuate the clinical effect of retroperitoneal laparoscopic nephron-sparing surgery. Methods From March 2007 to May 2008, 15 patients with local renal tumors underwent retroperitoneal laparoscopic partial nephrectomy by a single surgeon. Hilar control was achieved with bulldog clamps. Hook-cautery is used to circumscribe the tumor for resection by scoring the renal capsule circumferentially with a 2-10 mm margin around the tumor. Specimens are randomly extracted through tumor edges and immediately given to pathological frozen sections. The operative time, blood loss, postoperative stay, complications and the time of complete convalescence were recorded. Results Mean operative time was 110 minutes and mean time of hilar control was 26 minutes. Mean blood loss was 200ml. Mean postoperative stay was 9 days. Final pathological evaluation revealed negative positive margins in these cases. During 2-14 months follow-up there was no local recurrence. Conclusions Retroperitoneal laparoscopic partial nephrectomy for small renal tumors can be performed safely and effectively. Extended follow-up period is required to determine its long-term functional and oncological outcomes.