保留肾组织手术治疗肾癌

Nephron sparing surgery for renal cell carcinoma

１９８９年１２月～１９９７年４月行保留肾组织手术治疗肾癌１４例，其中双侧肾癌５例，对侧肾有病变或潜在功能受损的肾癌３例，对侧肾正常肾癌６例。肿瘤平均直径２９ｃｍ，病理分期为Ｔ１、Ｔ２。１４例中５例行剜出术，９例行肾部分切除术。本组术后无外科并发症，平均随访４６６个月，无瘤存活１２例，无局部复发。存活时间超过７年者２例，５年者４例，３年者１例，１年者２例，半年者３例。保留肾组织手术是早期局限性肾癌的有效治疗方法，可用于对侧肾正常。

From December 1989 to April 1997, nephron sparing surgery was performed for 14 patients with renal cell carcinoma, of which there were 5 patients with bilateral tumors, 3 with unilateral tumor and a damaged opposite kidney, and 6 with unilateral tumor and a normal opposite kidney. The mean size of the tumors was 2.9 cm. All the tumors were proved to be stage T 1 or T 2. Of the 14 patients, 5 underwent tumor enucleation and 9 underwent partial nephrectomy. There were no post operative surgical complications. Twelve patients (83.3%) were tumor free at a mean follow up of 46.6 months. Among them, 2 have survived more than 7 years, 4 more than 5 years, 1 more than 3 years, 2 more than 1 years, and 3 more than half a year. There were no local tumor recurrences. Nephron sparing surgery is effective and safe for patients with localized low stage renal cell carcinoma. It could be indicated for selected patients who present with a small localized unilateral tumor and a normal contralateral kidney.