腹腔镜肾部分切除术(附15例报告)

Laparoscopic partial nephrectomy (report of 15 cases)

目的评价腹腔镜肾部分切除术治疗肾脏肿瘤的临床效果。方法2004年1月至2005年4月采用腹腔镜经腹腔或后腹腔途径对15例肾肿瘤患者行肾部分切除术。男11例,女4例。平均年龄52岁(29～70岁)。局限性肾透明细胞癌12例,平均肿瘤直径3.0cm(2.0～4.0cm);肾血管平滑肌脂肪瘤3例,平均肿瘤直径4.5cm(3.5～6.0cm)。观察手术时间、术中出血量、住院天数、并发症及手术效果。结果15例手术顺利。平均手术时间120min(80～150min),术中平均出血量150ml(100～220ml),无输血、中转开放手术病例。术后无并发症,平均住院时间8d(7～9d)。随访2～16个月肿瘤无复发。结论腹腔镜肾部分切除术安全有效,但需长期随访以确定其远期疗效。

Objective To evaluate the clinical effect of laparoscopic partial nephrectomy for renal tumor. Methods From January 2004 to April 2005,15 patients （ 11 men and 4 women） with renal tumors underwent transperitoneal or retroperitoneal laparoscopic partial nephreetomy. The mean patient age was 52 years （ range, 29 - 70 years）. Among the 15 cases, 12 had renal clear cell carcinoma with a mean diameter of 3.0 cm （range,2.0 -4.0 cm） ,and 3 had renal angiomyolipoma with a mean diameter of 4.5 cm （range, 3.5 - 6.0 cm）. The operative time, estimated blood loss, postoperative hospital stay, complications and the time of complete convalescence were recorded. Results The operation was successfully performed in all the 15 patients. The mean operative time was 120 min （range,80 -150 min）. The mean estimated blood loss was 150 ml （range, 100 -220 ml） , and no blood transfusion or conversion to an open procedure was required. The mean hospital stay was 8 d （ range,7 - 9 d） and no complication occurred. During a follow-up of 2 - 16 months,no tumor recurrence was found. Conclusions Laparoscopic partial nephreetomy for small renal tumors can be performed safely and effectively. Extended follow-up period is required to determine its long-term effect.