单孔腹腔镜肾癌保肾手术68例经验总结

目的:总结单孔腹腔镜肾癌保肾手术临床应用经验,分析其适应证、安全性、手术方式的选择及治疗效果.方法:回顾性分析2010年12月-2021年6月笔者分别在上海长海医院(22例)、上海第九人民医院(46例)主刀完成的单孔腹腔镜肾部分切除术(13例)、单孔腹腔镜肾癌冷冻消融术(33例)和单孔腹腔镜免缝合肾部分切除术(22例)...

Laparoendoscopic single-site nephron sparing surgery for renal cell carcinoma: clinical experience with 68 cases

Objective:To summarize the clinical experience of laparoendoscopic single-site(LESS)partial nephrectomy,and analyze its indications,safety,surgical options,and therapeutic outcomes.Methods:We analyzed LESS partial nephrectomy(13cases),LESS cryoablation of renal cancer(33cases),and LESS sutureless partial nephrectomy(22cases)performed by the author from December 2010to June 2021,and evaluated surgical effects,complications,and short-and long-term outcomes.Among these cases,22were done at Shanghai Changhai Hospital and the other 46cases were performed at Shanghai Ninth People's Hospital.Results:All procedures were performed successfully and no additional incisions were added.The tumors'mean diameter was 2.6(1.5-6.2)cm and the mean length of hospital stay was 3.3(3-5)days after surgery.Postoperatively,one case underwent embolization with DSA because of blood loss,and the remaining cases showed no obvious intraoperative or postoperative complications.Conclusion:Classical LESS partial nephrectomy is feasible for exophytic kidney tumors.LESS cryoablation of renal cancer is associated with low risk,rapid recovery,and little impact on renal function,thus providing an ideal option for some renal tumor populations,such as those with poor general condition,many comorbidities,solitary renal tumors,double renal tumors,or fear of resective surgery.In patients with T_1a stage exophytic renal tumor,the LESS sutureless partial nephrectomy can be tried,which more precisely preserves the nephron and shortens the learning curve of LESS.