两种不同切缘保留肾单位手术治疗小肾癌临床疗效对比

The clinical efficacy of the different margins in nephron-sparing operation for small renal cell ;carcinoma

目的：分析比较两种不同切缘保留肾单位手术对小肾癌患者的临床影响。方法选取2008年9月至2013年4月收治住院采用保留肾单位手术的小肾癌患者64例，根据切缘厚度分为两组：30例患者切缘1～5 mm（A组），34例患者切缘6～10 mm（B组）。比较两组患者的手术情况以及术后3年复发率、存活率。结果 A组手术时间短于B组[（130.1±24.0）min比（152.3±28.0）min]，差异有统计学意义（P＜0.05）；两组引流时间、术后血肌酐水平比较差异无统计学意义（P＞0.05）。B组集合系统损伤发生率高于A组[64.71%（22/34）比40.00%（12/30）]，差异有统计学意义（P＜0.05）；两组3年后复发率、存活率比较差异无统计学意义（P＞0.05）。结论两种不同厚度的切缘保留均可以达到治疗肾癌的临床疗效，1～5 mm切缘并发症少，复发率及病死率不会升高，值得临床推广。

Objective To compare the clinical efficacy of different margins in nephron-sparing operation for patients with small renal cell carcinoma. Methods From September 2008 to April 2013, a total of 64 patients with local renal cell carcinoma （T1a period） and treated with nephron-sparing operation were selected, and the clinic data were analyzed. According to cutting edge size gotten from the surgery, the patients were divided in to A group （cutting edge 1-5 mm group, 30 cases） and B group （cutting edge 6-10 mm group, 34 cases）. The operation condition and recurrence rate and survival rate of two groups were compared. Results The operative time in A group was significantly shorter than that in B group：（130.1 ± 24.0） min vs. （152.3 ± 28.0） min, P〈0.05. The drainage time and the level of serum creatinine in two groups had no significant differences （P〉0.05）. The 3-year recurrence rate and 3-year survival rate in two groups had no significant differences （P〉0.05）. Conclusions The clinical efficacy of different margins in nephron-sparing operation for small renal cell carcinoma is similar. But 1- 5 mm cutting edge size nephron-sparing operation has less complications, and the recurrence rate and survival rate does not increase. It is worthy of spread .