保留肾单位手术治疗早期肾细胞癌疗效分析

Clinical outcomes of nephron sparing surgery for T1 renal cell carcinoma

目的 评价比较T1a和T1b期肾细胞痛患者行保留肾单位手术（NSS）的临床疗效.方法 回顾性分析1999年11月至2009年12月施行NSS治疗的101例T1期肾细胞癌患者临床资料,男性79例,女性22例,年龄28～79岁,平均52.3岁.根据肿瘤病理组织大小分为T1a期62例,T1b期39例.对两组患者一般资料、手术时间、术中出血量、术中输血率、术中肾动脉阻断率及阻断时间,以及术后并发症发生率、术后肿瘤复发转移及生存情况等进行统计学分析.结果 两组手术时间：T1a组为（151±80）min,T1b期为（158±50）min;术中出血量：T1a期（322±596）ml,T1b期（308±239）ml,两组比较差异无统计学意义（P=0.32和P=0.45）.术后随访8～102个月（平均38.4个月）,除T1b期患者中1例于术后36个月因肿瘤转移死亡外,其余100例患者无肿瘤复发.结论 对T1期肾细胞癌患者施行NSS可获得满意临床效果,且T1a与T1b期患者疗效相当.

Objective To investigate the safety and effect of nephron-sparing surgery （NSS）in treatment of T1a and T1b renal cell carcinoma. Methods Retrospective analyzed the clinical data of 101patients with T1 renal cell carcinoma underwent NSS from November 1999 to December 2009. Including 79male and 22 female with the mean age of 52. 3 years （ ranged 28 to 79 years）. Based on tumor pathologic diameter, 101 patients were divided into T1a group with 62 patient and T1b group with 39 cases.Demographic,intraoperative, postoperative and follow-up data were compared between the 2 groups. Results The operation were performed successfully in all the 101 cases. The mean operation time was （ 151 ± 80）min in group T1a and （ 158 ±50）min in group T1b with no statistical difference （P =0.32）. The mean blood loss was （ 322 ± 596） ml in group T1 a and （308 ± 239 ） ml in group T1 b （ P = 0. 45 ）. Postoperative followup ranged from 8 to 102 months with a mean of 38.4 months. One patient in T1b group died of distant metastasis 36 months after operation. Others were no tumor recurred. Conclusion Nephron-sparing surgery is safe and effective for the treatment of T1a and T1b renal cell carcinoma.