摘要
目的探讨保留肾单位的肾部分切除手术治疗小肾癌的安全性和合理性。方法对48例小肾癌患者行保留肾单位的肾部分切除术。男29例,女19例,平均年龄42岁(24～61岁)。平均肿瘤直径2.4cm(1.0～4.0cm)。病理分期T1N0M047例,双侧肾癌1例。评估肾蒂阻断时间、术后并发症及局部复发情况。结果48例手术均顺利完成,肾蒂阻断时间平均18min(12～26min)。术后出血3例、漏尿1例。平均随访21个月,1例术后6个月局部复发行根治性手术,1例出现远处转移而死亡,余未见复发或远处转移。结论保留肾单位的肾部分切除治疗小肾癌安全有效,手术指征可扩展至对侧肾脏正常的患者。
Objective To evaluate the safety and indications of nephron-sparing surgery for small renal cell carcinoma. Methods A total of 48 patients with localized renal cell carcinoma （3 cm or less in diameter） underwent nephron-sparing surgery. Of the 48 patients ,29 were male and 19 were female, with an average age of 42 years. The mean diameter of the tumors was 2.4 cm and the T1N0M0 stage was found in 47 cases and 1 case had bilateral renal cell carcinoma. The evaluated factors included positive margin,intraoperative renal ischemia time, postoperative complications and incidence of postoperative local recurrence. Results The procedure was successful in all 48 patients with the mean intraoperative renal ischemia time of 18 rain （12-26 min）. The postoperative complications included bleeding （3 cases）,leakage of urine （1 case）. None had positive margin. During the follow=up period （mean,21 months）, 1 case underwent radical nephrectomy because of local recurrence 6 months after operation and 1 case died of distant metastasis. The remaining cases had no recurrence or metastasis. Conclusions Nephron-sparing surgery for small renal cell carcinoma is a safe and effective procedure,the indications for which may be expanded to patients with a normal contralateral kidney.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第2期97-100,共4页
Chinese Journal of Urology
