后腹腔镜肾细胞癌根治术63例临床分析

Clinical Analysis of 63 Cases of Retroperitoneoscopic Radical Nephrectomy

目的:探讨后腹腔镜肾癌根治术的手术技巧和临床效果。方法:回顾性分析2008年1月～2010年1月行后腹腔镜肾细胞癌根治术患者63例临床资料:肿瘤位于左侧41例,右侧22例;肾上极18例,中极31例,下极14例。肿瘤直径2.1～7.8 cm,平均5.3 cm。术前肿瘤分期为T_1 N_0 M_0 59例,T_1 N_1 M_0 2例,T_2N_0 M_0 2例。结果:手术时间94～198 min,平均125 min。术中出血量35～400 ml,平均84 ml。术后住院时间7～12天,平均8天。术后肠功能恢复时间1～2天。术后随访6～24个月,平均15个月,无局部复发或远处转移。结论:后腹腔镜肾细胞癌根治术具有出血少、术后恢复快的优点,是一种安全、有效的手术方法。

Objective： To investigate the surgical techniques and clinical effect of retroperitoneoscopic radical nephrectomy. Methods：The clinical data of 63 patients （34 males and 29 females） treated by retroperitoneoscopic radical nephrectomy from January 2008 to January 2010 were analyzed retrospectively. Their average age was 56 years,ranging from 35 to 72. 41 cases of the tumors were located in the left, and 22 in the right kidney, 18 were in the upper,31 were in the middle and 14 were in the lower pole. The tumors averaged 5.3 cm in diameter,ranging from 2.1 to 7.8 cm, 59 was T1 N. M.2 was the T1 N1 M. and 2 was the T2.N. M. stage. Results：The operation time ranged from 94 to 198 minutes （mean 125 minutes） ,the blood loss from 35 to 400 rnl （mean 84 ml） ,the postoperative hospital stay from 7 to 12 days （mean 8 days） and the time for intestinal function recovery from l to 2 days. The patients were followed up for 6-24 months（mean 15 months）, which revealed no relapse or metastasis. Conclusions：Retroperitoneoscopic radical nephrectomy is a safe and effective surgical option for the treatment of renal cell carcinoma,with less bleeding and rapid recovery.