后腹腔镜肾部分切除术39例报告

Retroperitoneal Laparoscopic Partial Nephrectomy (Report of 39 Cases)

目的：总结腹腔镜保留肾单位的肾部分切除术治疗T1期肾癌的手术方式和临床疗效.方法：回顾性分析39例行腹腔镜保留肾单位手术的T1期肾癌患者的临床资料,其中男23例,女16例,平均年龄53岁.肿瘤直径2.7～5.1 cm,平均3.6 cm.所有患者均行腹腔镜保留肾单位的肾部分切除术.结果：39例手术均获成功,无术中、术后并发症.平均手术时间（125.8±34.6）min;平均热缺血时间（23.8±3.9） min;平均术中出血量（146.9±41.5） ml.术后病理为32例肾透明细胞癌,5例颗粒细胞癌,2例嗜酸性细胞瘤,切缘均阴性.34例患者获随访,随访2～32个月,平均11个月,无肿瘤局部复发和远处转移.结论：腹腔镜肾部分切除术治疗局限性肾癌安全可靠,短期随访效果肯定.

Objective： To summarize the surgical technique and therapeutic effect of laparoscopic nephron sparing partial nephrectomy for T1 stage renal tumor. Methods：To retrospectively analyze the clinical data of 39 cases underwent laparoscopic nephron sparing surgery for T1 stage renal tumors. 23 cases were male and 16 cases were female, and the average age was 53 years old. The tumor size was 2.7-- 5.1 cm, and the average diameter of tumor masses was 3.6 cm. All patients underwent laparoscopic nephron sparing partial nephrectomy. Results： All operations were completed successfully, no intraoperative and postoperative complications. The average operating time was（125.8 ± 34.6） minutes, the average time of warm ischemia was （23.8 ± 3.9） min. And average blood loss was （ 146.9 ± 41.5） ml. The postoperative pathology were as follows： 32 eases were renal cell carcinoma, 5 cases were granular cell carcinoma, 2 cases were renal oncocytoma, and the pathological margins were nega- tive. 34 cases were followed up from 2 to 32 months, the average follow - up time was 11 months. The follow - up indicated there was no local recurrence or distant metastasis. Conclusion： Laparoscopic nephron sparing surgery is a safe and feasible treatment for local renal tumors. The short - term follow - up were satisfied.