摘要
目的 :探讨肾癌手术治疗的方法与效果。方法 :分析根治术的 5 9例 ,男 39例 ,女 2 0例 ,年龄 2 0～ 6 7岁 ,平均 4 9岁。右侧 38例 ,左侧 2 1例。手术采用 11肋间切口 4 6例 ,改良肋缘下切口 7例 ,改良肋缘下切口加框架拉钩 4例 ,胸腹联合切口 2例。结果 :透明细胞癌 4 8例 ,颗粒细胞癌 5例 ,混合细胞癌 3例 ,乳头状腺癌 2例 ,未分化癌 1例。Robson分期 : 期 2 7例 , 期 2 0例 , 期 7例 , 期 5例。随访 5 6例 ,3～ 72个月 , 期 2 7例至今均存活 , 期 19例术后生存15～ 6 6 (平均 30 )个月 , 期 6例术后生存 3～ 5 4 (平均 15 )个月 , 期 4例生存 3～ 6 (平均 3.5 )个月。 5 a生存率在 组 ～ 期 75 .1% , 期 19.9% ; 组 I～ 期 73.8% , 期 2 1.5 % ,两组无统计学差异 ( P>0 .0 5 ) , 期 13.1%。淋巴结转移 7例 5 a生存率为 0。结论 :肾癌根治术仍是肾癌主要治疗方法 。
Objective:To evaluate methods and effect of radical surgery in patients with renal cell carcinoma.Methods:Data of fifty nine patients (male 39, f e male 20, age ranging from 20 to 67) with renal cell carcinoma (right side 38, left 21) undergoing nephrectomy were reviewed. Inter ribs 11 incision was performed in 46 cases, reformed below costal margin incision in 7 cases, among which, frame retractor plus in 4 cases, and abdominothoracic incision in 2 cases.Results:Among fifty nine patients, there were 48 clear cell carcinomas, 5 granular cell carcinomas, 3 mixture cell carcinomas, 2 polypoid adenocarcinomas and 1 undifferentiated carcinoma, and 27 in stage I, 20 in stageⅡ, 7 in stage Ⅲ and 5 in stage Ⅳ (Robson stage). The following up visit (3 to 72 months), showed that 27 cases in stage I all survived, 19 in stage Ⅱ from 15 to 66(average 30)months, 6 cases in stage Ⅲ from 3 to 54(average 15)months, and 4 cases in stage Ⅳ from 3 to 6(average 3.5)months. The 5 year survival rate was 75.1 % for cases in stage Ⅰ~Ⅱ, 19.9 % for cases in stage Ⅲ in inter ribs 11 incision g roup, and 73.8 % for cases in stage I~Ⅱ, 21.5 % for cases in stage Ⅲ in reform ed below costal margin incision group (P> 0.05), and 13.1 % for cases in stage Ⅳ. The 5 year survival rate was 0 for 5 cases with extensive lymphatic metastasis.Conclusion:Radical surgery was the most effective means to treat early renal cell carcinoma. Reformed below costal margin in cision mode could not improve the survival of the patients with renal cell carcinoma.
出处
《中国误诊学杂志》
CAS
2004年第10期1582-1584,共3页
Chinese Journal of Misdiagnostics
基金
兰州军区后勤部优秀科技人才资助项目 (2 0 0 1~2 0 0 5)
