腹腔镜下微波消融剜除术治疗肾脏肿瘤的疗效分析

Laparoscopic microwave ablation assisted renal tumor enucleation for the treatment of renal tumor

目的探讨腹腔镜下微波消融肾肿瘤剜除术治疗肾脏肿瘤的疗效与安全性。方法本组84例肾肿瘤患者,予以腹腔镜下辅助微波消融,尔后手术剜除肾肿瘤,记录术中出血量、手术时间,观察术中、术后并发症及疗效与安全性。结果 84例患者手术均顺利完成,术中均未阻断肾动脉,无术中大出血或中转开放手术,出血量为50~350ml,手术时间为70~120min。术后病理诊断为肾透明细胞癌60例,血管平滑肌脂肪瘤16例,嗜酸性细胞瘤4例,嫌色细胞癌2例,乳头状肾细胞癌2例。术中血管平滑肌脂肪瘤普遍出血较多。术后血管平滑肌脂肪瘤出血1例。全部病例随访12个月,无肿瘤复发、远处转移或死亡病例。结论腹腔镜下微波消融肾肿瘤剜除术是一种安全有效的保留肾单位的手术方式,具有出血量少、手术时间短、术后并发症少等优点。

Objective To investigate the efficacy and safety of laparoscopic microwave ablation combined with partial nephrectomy for renal neoplasms. Methods 84 patients with renal neo- plasms underwent laparoseopic assisted microwave ablation, and then the neovascularization was e- nucleated. The intraoperative blood loss, operation time, postoperative complications and efficacy and safety were observed. Results 84 cases of patients were successfully completed, all operations did not block the renal artery, no intraoperative bleeding or transit open surgery, bleeding volume of 50-350 ml, the operation time of 70-120 rain. Pathological diagnosis of renal clear cell carcinoma in 60 cases, 16 cases of vascular smooth muscle lipoma, eosinophil 4 cases, chromophobe cell carcino- ma in 2 cases, 2 cases of papillary renal cell carcinoma. Intraoperative vascular smooth muscle lipoma generally more bleeding. One case of postoperative vascular smooth muscle lipoma hemorrhage. All cases were followed up for 12 months without tumor recurrence, distant metastasis or death. Con- clusions Laparoscopic microwave ablation of renal neoplasms is a safe and effective method for pre- serving nephrons. It has the advantages of less bleeding, shorter operation time and less postopera- tive complications.