保留肾单位手术治疗肾肿瘤69例分析

目的评价保留肾单位手术(NSS)治疗肾肿瘤的效果。方法回顾性分析了1985年8月~2005年7月在我院实施NSS的66例肾肿瘤患者的临床资料,其中3例为双侧肾肿瘤,分别施行了两次肾部分切除术。结果肾部分切除术63例,肾肿瘤剜除术6例,术中阻断肾蒂45例。所有病例手术切缘均为阴性。术后出现并发症7例,围手术期无患者出现急性肾功能衰竭。42例肾细胞癌患者获随访,平均随访时间55·4个月,5年生存率及5年无瘤生存率分别为97·3%和90·7%。结论对于适合的肾肿瘤患者,NSS是一种安全有效的术式,可在不降低生存率的前提下保留患肾功能。

Nephron-sparing surgery for 69 patients with renal tumors

Objective To evaluate the results of nephron-sparing surgery(NSS) for renal tumors. Methods A retrospective analysis was performed for the clinical data of 66 patients who were affected by renal tumors and treated with NSS. Results Among 66 cases,63 were treated with partial nephrectomy and 6 with enucleation. The renal vessel was clamped in 45 cases intraoperative. The histological subtypes included clear cell carcinoma in 40 cases, papillary renal cell carcinoma(RCC) in 2 cases, chromophobe RCC in 2 cases, angiomyolipoma in 24 cases, and adenoma in one case. Surgical margins were negative in all cases. Seven patients had postoperative complications and no perioperative acute renal failure occurred. Among 44 cases with renal cell carcinoma, 42 were followed for mean 55.4 months. The overall and disease-free 5-year survival rates were 97.3% and 90.7%, respectively. Conclusion NSS is a effective and safe operation for selected patients with renal tumors, providing functional advantage gained by the maximal preservation of unaffected renal parenchyma without sacrificing cancer control.