摘要
目的探讨零缺血小切口肿瘤剜除术治疗T1b期肾癌的手术技巧及临床应用效果。方法回顾性分析46例分别采用小切口方式(分为阻断肾蒂与不阻断肾蒂)、传统开放(分为阻断肾蒂与不阻断肾蒂)和腹腔镜方式(均阻断肾蒂)治疗T1b期肾癌的临床效果。结果小切口组在术中出血量、手术时间、术后恢复方面均较其他两种术式有显著优势(P〈0.01);小切口组内阻断肾蒂与未阻断肾蒂相比,术前、术后6个月肾小球滤过率(GFR)变化量分别为(5.1±1.7)mL/min和(1.1±0.8)mL/min,差异有统计学意义(P=0.008)。术后随访24~108个月,3组肿瘤局部复发差异无统计学意义(χ^2=0.46,P=1.0)。结论在T1b期肾癌的治疗中,零缺血小切口肿瘤剜除术在有效的切除肾脏肿瘤的基础上,能够最大限度地保护肾功能,减少手术创伤。
Objective To evaluate the feasibility and clinical efficacy of zero ischemia mini-flank for simple enucleation for T1b renal cell carcinoma.Methods The clinical data of 46 cases of cT1b renal masses treated with mini-flank(n=17),traditional operation(n=18)and laparoscopic surgery(n=11)were retrospectively reviewed.Results The mini-flank approach had more advantages than the other two approaches in the average operation time,intraoperative blood loss,and recovery of bowel function(P〈0.01).Within the mini-flank group,there was significant difference between those with hilar clamping[GFR=(5.1±1.7)mL/min]and without hilar clamping[GFR=(1.1±0.8)mL/min](P=0.008).During the follow-up of 8 to 60 months,there was no difference in the recurrence rate among the three groups(χ^2=0.46,P=1.0).ConclusionZero ischemia mini-flank for simple enucleation for T1b renal cell carcinoma can remove the specimen with a small incision and protect the function of kidney.
出处
《现代泌尿外科杂志》
CAS
2016年第5期372-375,共4页
Journal of Modern Urology
关键词
保留肾单位手术
零缺血
小切口
肾癌
simple enucleation
zero ischemia
mini-incision
renal cell carcinoma