保留肾单位的手术治疗肾癌(附16例报告)

Nephron sparing surgery for renal cell carcinoma (Report of 16 cases)

目的 :探讨保留肾单位的手术治疗早期小肾癌的效果。方法 :行保留肾单位手术治疗肾癌 16例 ,其中双侧肾癌 2例 ,孤立肾肾癌 1例 ,对侧肾有病变或潜在功能受损肾癌 4例 ,对侧肾正常肾癌 9例。肿瘤平均直径 2 .8cm。 6例只行肿瘤切除术 ,10例行部分肾切除术。病理分期 :T110例 ,T2 6例。结果 :平均随访 5 2 .8个月 ,2例出现局部复发 ,1例死于肺部转移。生存时间 >8年 2例 ,>5年 8例 ,>3年 10例 ,>1年 15例。结论 :保留肾单位的手术是早期局限性肾癌的有效治疗方法 ,直径≤ 4cmT1～T2

Purpose:To evaluate the clinical effects of nephron sparing surgery in patients with small low stage localized renal cell carcinoma.Methods:From October 1993 to December 2002,Nephron sparing surgery was performed for 16 patients with renal cell carcinoma. of which there were 2 patients with bilateral tumors, 4 with unilateral tumor and a compromised contralateral kidney, and 9 with unilateral tumor and a normal contralateral kidney, another is a solitary kidney.The mean diameter of tumors was 2.8 cm. Of the 16 patients, 6 underwent tumor enucleation and 10 underwent partial nephrectomy. All the tumors were proved to be stage T 1 or T 2.Results:A mean 52.8 months follow up showed that 2 patients had a local recurrence and 1 died of lung metastasis. Among them, 2 have survived more than 8 years, 8 more than 5 years, 10 more than 3 years, and 15 more than 1 year.Conclusions:Nephron sparing surgery provides effective therapy for patients with localized low stage renal cell carcinoma. It could be indicated for selected patients who present with lesions less than 4cm and T 1～T 2 localized unilateral tumor and a normal contralateral kidney.