后腹腔镜肾癌根治术67例报告

Clinical results of 67 cases of retroperitoneoscopic radical nephrectomy

目的：探讨后腹腔镜肾癌根治术的手术经验和临床效果。方法：2006年1月至2007年12月，后腹腔镜肾癌根治术67例。男44例，女23例。年龄23-80岁，平均52岁。肿瘤位于右侧35例，左侧32例；位于肾上极15例，中极29例，下极23例。肿瘤直径1.5-8.0 cm，平均4.64 cm。术前肿瘤分期：T1N0M064例，T2N0M03例。结果：手术时间为55~253 min，平均110 min。术中出血10-500 ml，平均98 ml，前10例平均出血152 ml，后10例平均出血量仅58 ml。术后住院7-12 d，平均8 d。术后肠功能恢复时间1-2 d。术后随访2-26个月，平均12.1个月。无局部复发或远处转移，无切口或操作孔肿瘤种植。结论：后腹腔镜肾癌根治术具有微创、出血少、术后恢复快等优点，是一种安全、可靠的手术方法。

Objective： To investigate the surgical techniques and clinical effect of retroperitoneoscopic radical nephreetomy. Methods： The clinical data of 67 patients （44 males and 23 females） treated by retroperitoneoscopic radical nephrectomy from January 2006 to December 2007 were analyzed retrospectively. Their average age was 52 years, ranging from 23 to 80. Thirty-five of the tumors were located in the fight and 32 in the left kidney; 15 in the upper, 29 in the middle and 23 in the lower pole. The tumors averaged 4.64 cm in diameter, ranging from 1.5 to 8.0 cm, 64 in the T1N0M0 and 3 in the T2N0 M0 stage by the criteria of the American Joint Commission for Cancer Staging （AJCCS）. Results： The operation time ranged from 55 to 253 minutes （mean 110 min） , the blood loss from 10 to 500 ml （mean 98 ml）, the postoperative hospital stay from 7 to 12 days （mean 8 d） and the time for intestinal function recovery from 1 to 2 days. The patients were followed up for 2 - 26 （ mean 12.1 ） months, which revealed no relapse, metastasis or port-site tumor seeding. Conclusion： Retroperitoneoseopic radical nephreetomy, with the advantages of minimal invasiveness, less bleeding and rapid recovery, is a safe and effective surgical option for the treatment of renal cell carcinoma.