后腹腔镜肾部分切除术治疗T1b期肾癌

目的:探讨后腹腔镜肾部分切除术治疗T1b期肾癌的临床经验及疗效。 方法:回顾性分析2007年11月至2011年6月15例T1b期肾癌患者的临床资料，其中男10例，女5例，平均年龄(56.2±9.8)岁，其中左侧8例，右侧7例。肿瘤平均直径（5.5±1.4）cm，15例患者R.E.N.A.L.评分均为中度复杂性（7-9分），其中肿瘤靠近肾门血管2例；15例患者均行后腹腔镜肾部分切除术。结果:所有手术均顺利完成，无中转开放，围手术期无严重并发症。平均手术时间(100±23.6 )min，术中平均热缺血时间（21.3±8.6）min,术中平均出血量(35.3±11.6)ml，术后尿漏1例,肌酐短暂升高1例；术后平均住院时间(5.7±1.8)d，术后平均随访(21.2±10.1) m，所有患者肾功能正常且未见肿瘤复发及转移。结论:后腹腔镜肾部分切除术治疗T1b期肾癌安全、有效，具有创伤小、恢复快的优点，但其远期疗效尚需大样本对照研究和长期随访观察。

Retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal cell carcinoma

Objective To introduce the clinical experience and effects of retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal cell carcinoma. Methods Fifteen patients (10 males and 5 females) with T1b renal cell carcinoma who were treated from Nov. 2007 to Jun. 2011 were retrospectively analyzed. The patients had a mean age of (56.2±9.8) years old and a mean tumor size of (5.5±1.4) cm in diameter, with 8 cases on the left side and 7 cases on the right side. All of the 15 patients received retroperitoneal laparoscopic partial nephrectomy. Results All the 15 cases were operated successfully without conversion to open surgery, and there were no severe perioperative complications. The mean operation time was (100±23.6) min, mean warm ischemia time (WIT) was (21.3±8.6) min, and the mean blood loss was (35.3±11.6) ml. Postoperative urinary leakage was found in one case and serum creatinine transient increase was found in one case. The mean postoperative hospital stay was (5.7±1.8) d. All patients had normal renal function and had no tumor recurrence or metastasis during a mean follow-up of (21.2±10.1) months. Conclusion Retroperitoneal laparoscopic partial nephrectomy is safe and effective for treatment of patients with T1b renal cell carcinoma, with less trauma and faster recovery; however, the long-term effects still need large sample studies and long-term follow-up.