双侧肾癌27例诊治及随访分析

Diagnosis,treatment and follow-up analysis of 27 cases of bilateral renal carcinomas

目的探讨双侧肾癌的诊治及预后。方法回顾性分析2006年至2019年我科收治的27例双侧肾癌患者的临床诊治资料、家族史及预后随访资料。结果27例患者均经影像学检查明确诊断,21例患者行手术治疗(12例患者一侧行肾根治性切除术、对侧行肾部分切除术,9例患者行双侧肾部分切除术,其中5例患者行机器人辅助腹腔镜下双侧肾部分切除术),1例患者行冷冻消融术,5例患者未行手术治疗。手术均成功,术后病理证实均为肾癌,并根据个体情况给予相应治疗及随访。结论临床上双侧肾癌少见,治疗以手术为主,术后治疗应该个体化。患者的预后主要受肿瘤临床和病理分期的影响,术后个体化的治疗和随访也起到重要的作用。

Objective To explore the diagnosis,treatment and prognosis of bilateral renal cell carcinomas.Methods The clinical data,family history and prognosis follow-up of 27 patients with bilateral renal carcinomas admitted to our department from 2006 to 2019 were retrospectively analyzed.Results All the 27 patients were diagnosed by imaging examination,and 21 patients were treated by operation(12 patients underwent radical nephrectomy on one side and partial nephrectomy on the other side,9 patients underwent bilateral partial nephrectomies,including 5 patients who underwent robot-assisted laparoscopic bilateral partial nephrectomies),1 patient underwent cryoablation and 5 patients did not undergo surgical treatment.The operations were all successful and renal cell carcinoma was confirmed by postoperative pathology.The corresponding treatments and follow-up were given according to the individual conditions.Conclusions Bilateral renal cell carcinomas are rare in clinic,and surgery is the main treatment.Postoperative treatment should be individualized.The prognosis of patients is mainly affected by clinical and pathological stages,and individual treatment and follow-up also play an important role.