保留肾单位手术治疗肾癌(附46例报告)

目的:探讨保留肾单位手术治疗肾癌的安全性和疗效。方法:对1993年2月～2006年10月共46例采用保留肾单位手术的肾癌患者的临床资料进行回顾性分析,其中双侧肾癌4例,孤立肾癌3例,对侧肾有病变或潜在功能受损的肾癌25例,对侧肾正常的肾癌14例。结果:46例患者术前均未发现转移灶。术后组织病理学结果示肾透明细胞癌36例,颗粒细胞癌6例,混合性细胞癌4例。术后42例(91%)获随访,随访时间6～160个月,平均随访65个月。5、10年生存率分别为94%、86%。3例术后出现局部复发和远处转移。结论:保留肾单位手术治疗肾癌安全有效,手术指征可扩展至对侧肾脏正常的患者。

Nephron-sparing surgery for renal cell carcinoma

Objective:To investigate the safety and effect of nephron-sparing surgery in treatment of renal cell carcinoma.Methods:From February 1993 to February 2006,46 cases of renal cell carcinoma underwent nephron-sparing surgery.The clinical data and long-term follow-up results were analyzed retrospectively.Of 46 cases,there were 4 patients with bilateral tumors,3 with solitary kidney tumors,25 with unilateral tumor and a damaged opposite kidney,and 14 with unilateral tumor and a normal opposite kidney.Results:None of the patients was found to have metastasis preoperatively.Postoperative pathology showed renal clear cell carcinoma in 36 cases,granular cell carcinoma in 6,and mixed cell carcinoma in 4.Postoperatively,42 of the 46 patients(91%)were followed for 6-160 months with a mean of 7 65 months.The 5-year and 10-year survival rates were 94% and 86%,respectively.Three patients died of metastasis from renal carcinoma.Conclusions:Nephron-sparing surgery for renal cell carcinoma is a safe and effective procedure,the indications for which may be expanded to patients with a normal contralateral kidney.