肾盂后逆行游离控制肾蒂的肾癌根治术

Radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedide

目的探讨肾盂后逆行游离控制肾蒂的肾癌根治术的效果。方法将102例临床分期为氏期以前的肾癌患者分成两组：采用经腹传统控制肾蒂方法（传统组）50例，采用经腹肾盂后逆行游离控制肾蒂方法（研究组）52例。对两组手术时间、术中出血量、术后1年局部肿瘤复发率及远处转移率进行比较。结果102例患者均顺利完成手术，康复出院并按计划随访1年。传统组平均手术时间（130±37）min，平均术中出血量（400±306）ml；研究组平均手术时间（99±28）min，平均术中出血量（280±225）ml，两组比较差异有统计学意义（P〈0．05）。随访1年，传统组局部复发率2％（1／50），远处转移率6％（3／50）；研究组分别为2％（1／52）和4％（2／52），两组比较差异无统计学意义。结论肾盂后逆行游离控制肾蒂的肾癌根治术操作简单，手术时间短，出血量少，能降低手术风险，疗效满意，值得推广。

Objective To explore the effect on radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle. Methods The patients with pre-T3a stage kidney cancer were divided into two groups, 50 patients in traditional surgical group （traditional group） and 52 patients in post-pyelic retrograde free control of renal pedicle group（research group）. The surgical duration, hemarrhage volume, local tumor recurrence in one year after operation, and distal metastasis rate had been compared between the two groups. Results One hundred and two patients underwent successful operations and had one year of follow-up as scheduled after being discharged from hospital. The traditional group took （130 ± 37 ） min for surgical duration, and had （400 ± 306） ml of hemarrhage volume; and the research group took （99± 28） min for surgical duration, and had （280 ± 225） ml of hemarrhage volume,there were significant difference between the two groups （P 〈 0.05 ）. After one year of follow-up, 2% （1/50） of local recurrence rate and 6%（3/50） of distal metastasis rate occurred in the traditional group,and only 2% （1/52） of local recurrence rate and 4% （2/52） of distal metastasis rate happened in the research group. There were no obvious difference between the two groups. Conclusion The radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle has such features as easy performance, short surgical duration, less hemarrhage, and can lower the surgical risk, achieve satisfactory efficacy and deserve popularization.