双侧肾母细胞瘤40年治疗经验

目的 探讨双侧肾母细胞瘤(BWT)治疗方法的特殊性及终生随诊的必要性。方法 收集我院40年来肾母细胞瘤235例。其中双侧患者15例，占6．39％。先后发病者均作先发病侧全肾切除术，后发病肾作半肾切除术。同时发病者早年病例治疗方法包括巨大肿瘤一侧肾切除，对侧除一例活检外，均作肿瘤摘除或半肾切除术，术后化疗，部分放疗 化疗。结果 随诊结果6例存活，时间最短4年，最长23年，平均9年6个月。长期生存率33％。结论 指出首诊时排除BWT的重要性，局部根治性手术与BWT患者的长期生存呈正相关。术中阻断肾蒂血流时间直接影响残。肾的生存质量。BWT术后复发再切除化疗的积极治疗观点对BWT患者的长期生存起着重要作用。终生随诊是必要的。

Treatment of Bilateral Wilms Tumor-A 40 Years Experience

Objective To investigate the particularity of therapy of bilateral nephroblastoma (BWT)and necessity of lifetime follow-up.Method235cases with nephroblastoma had been treated in our hospital.15cases suffering from bilateral nephroblastoma.It accounted for6.3%of all cases.10cases were male and5cases were female.For patients who suffered from bilateral nephroblastoma at different time,the first sick kidneys had been resected and the opposite ones had been half removed.For patients who suffered from bilateral nephroblastoma at the same time,the sick kidneys with large tumor had been completely resected and tumors in the opposite kidneys had been removed or the opposite kidneys had been half removed except that biopsy had been carried out in one case.All cases were treated with chemotherapy postoperation and some cases were treated with chemotherapy and radiotherapy.Results6cases survived for long term.The shortest survival duration was4years,the longest was23years and the average was8years and8months.The survival rate was40.0%.Conclusions It is very important to exclude BWT in the first diagnosis.Local radical operation has positive correlation with increase of long-term survival rate of patients with BWT.Time of blocking blood flow of renal pedicle during operation could directly affects the survival quality of residual kidney.The resection of reoccurred tumor and chemotherapy are also very important for long term survival rate of patients with BWT.Lifetime follow-up is necessar