摘要
目的：探讨后腹腔镜肾部分切除术（RLPN）治疗。肾肿瘤的手术方法及临床效果。方法：2010年3月～2012年12月，对23例肿瘤直径≤4cm的肾肿瘤患者行RLPN，术中采用全层“8”字形间断缝合和免打结分层缝合法修补肾脏创面缺损，观察肾脏热缺血时间、手术时间、术中出血量、术后住院天数、围手术期和近期并发症及手术效果。结果：23例手术均获成功，手术时间70～130min；中位数90min肾脏热缺血时间15～30min，中位数25min；术中出血量50-260ml，中位数80ml；无术中输血。术后病理示所有肿瘤切缘均阴性。术后住院时间7～13d，中位数8d；术后无出血、尿瘘等并发症发生，围手术期无死亡及二次手术切除肾脏病例。术后平均随访12（3～24）个月，全部无瘤生存，肿瘤未见局部复发及远处转移。结论：RLPN治疗肾肿瘤（肿瘤直径≤4cm）安全、有效，具有较好的临床可行性。
Objective： To investigate feasibility and safety of retroperitoneal laparoscopic partial nephrectomy （RLPN） for renal tumors. Method： From March 2010 to December 2012, 23 patients with renal tumor （≤ 4 cm in diameter） underwent RLPN. Full-thickness ＂8＂ suture and knot-free layered seam were used to repair the renal wound. Renal warm ischemia time, operative time, intraoperative blood loss, postoperative hospital stay, periop- erative and short-term complications, effects of operations were observed. Result： All surgeries were successful. The median operation time was 90 （range, 70-130） min. The median kidney warm ischemia time was 25 （range, 15-30） rain. The median intraoperative blood loss was 80 （range, 50-260） ml. No intraoperative blood transfusion occurred. Pathological examination showed all tumor margins were negative. The median postoperative hospital stay was 8 （range, 7-13） d. No postoperative bleeding, urine leakage, perioperative death or secondary surgical removal of the kidney occured. There were no local recurrence or distant metastasis during the mean follow-up pe- riod of 12 （range, 3-24） months. Conclusion： RLPN for treatment of renal tumors （diameter ~ 4 em） is safe, effective and clinically feasible.
出处
《临床泌尿外科杂志》
2014年第3期200-202,共3页
Journal of Clinical Urology
关键词
后腹腔镜
肾部分切除
肾肿瘤
retroperitoneal laparoscopy
partial nephrectomy
renal tumor
