保留肾单位手术治疗肾血管平滑肌脂肪瘤的疗效观察

目的探讨保留肾单位手术（NSS）治疗肾血管平滑肌脂肪瘤（RAML）的安全性及有效性。方法对56例采用NSS治疗的RAML患者的临床资料回顾性分析，其中肿瘤剜除术35例，肾部分切除21例，4例患者术前行选择性肾动脉栓塞术。结果术中切除肿瘤平均直径（5．6±2．7）cm，术中平均失血量（140±75）ml，术后无大出血、尿瘘。51例患者获得随访，平均随访36月（6-120月），术后肾功能相对稳定，未见肿瘤复发。结论保留肾单位手术是治疗RAML的较好方法，有效地控制出血和保护肾脏功能是手术成功的关键。

Clinic Analysis of Nephron Sparing Surgery for Renal Angiomyolipoma

Objective To evaluate the safety and efficacy of nephron sparing surgery（NSS） for renal angiomyolipoma （RAML）. Method The clinical data of 56 cases with RAML treated by NSS were retrospectively analyzed. 4 patients were underwent selective arterial embolization before surgical operation. Tumor enucleation in 35 patients and partial nephrectomy in 21 patients were performed. Result The mean size of tumor enucleated was （5.6±2.7）cm, the mean blood loss was（140±75）ml, none of the patients developed hemorrhage or urinary fistula. 51 patients were followed up, with the mean follow-up time of the patients of 36 （rang 6 to 120） months. Postoperative serum creatinine was stable; no patient had a local recurrence. Conclusion NSS can be performed with satisfactory result in RAML, and effective control of hemorrhage and retain the renal function.