后腹腔镜下肾部分切除术治疗早期肾癌

目的 探讨后腹腔镜下肾部分切除术治疗早期肾癌的可行性及安全性.方法 肾癌患者65例.男45例,女20例.平均年龄52岁.临床分期均为T_1N_0M_0.肿瘤直径1.8～4.0 cm,单发.行后腹腔镜下肾部分切除术.术中用bulldog血管夹阻断肾动脉,距肿瘤边缘0.5～1.0 cm处完整切除肿瘤.结果 中转开放手术3例,改为根治性肾切除术1例.手术时间平均120(70～210)min,肾动脉阻断时间平均32(21～55)min,术中出血量平均60(20～200)ml,平均住院10.5(7～15)d.术后发生肾周血肿1例,尿瘘1例,保守治疗后痊愈.62例患者随访3～56个月,未见肿瘤复发.残肾功能良好.结论 后腹腔镜下肾部分切除术是治疗直径≤4 cm、局限性单发肾癌的有效方法.

Retroperitoneal laparoscopic partial nephrectomy in the treatment of early stage renal cell carcinoma

Objective To evaluate the feasibility and the safety of retroperitoneal laparoscopic partial nephrectomy(LPN)for early stage renal cell carcinoma.Methods Retrospectively analyzed the medical records of 65 patients with single localized tumor.Fourty five cases were males and twenty cases were females.The mean age was 52 years.The clinical stage was T_1N_0M_0 in all patients.The renal artery was blocked with bulldog clamp and the tumor was resected with a margin of 5 to 10 mm of healthy renal parenchyma.Results Three patients required conversion to the open partial nephrectomy and one required conversion to the laparoscopic radical nephreetomy.The mean operative time was 120(70-210)min;the median warm-ischemia time was 32(21-55)min;the median overall estimated blood loss was 60(20-200)ml and the hospital stay was 10.5(7～15)d.During the follow-up of 3-56 months,All patients were alive without recurrence and had normal renal function.Conclusions Retroperitoneal laparoscopic partial nephrectomy is a treatment for early localized renal cell carcinoma.