后腹腔镜肾部分切除术治疗局限性肾癌的临床效果.docVIP

后腹腔镜肾部分切除术治疗局限性肾癌的临床效果 　　【摘要】 目的：探讨后腹腔镜肾部分切除术治疗局限性肾癌的临床效果。方法：回顾性分析2013年1月-2016年7月收治的44例局限性肾癌患者的临床资料。肿瘤位于左侧17例，右侧27例。肿瘤直径1.0～5.1 cm，平均（2.8±1.3）cm。所有患者均在后腹腔镜下距肿瘤边缘0.5～1.0 cm处完整切除肿瘤。结果：手术均顺利完成，无中转开放及脏器损伤病例。手术时间60～150 min，平均（85.6±25.3）min，术中热缺血时间15～38 min，平均（23.2±6.9）min，术中出血量50～200 ml，平均（110.3±45.8）ml。术后尿漏者1例，肾周血肿者1例，保守治疗后痊愈。术后病理示手术切缘均为阴性。术后随访1～42个月，平均（20.5±5.3）个月，所有患者肿瘤无局部复发及远处转移。结论：后腹腔镜肾部分切除术治疗局限性肾癌安全、可行，创伤小、恢复快，同时可最大限度保留患者肾功能。 　　【关键词】 肾癌； 后腹腔镜； 肾部分切除术 　　中图分类号 R737.11 文献标识码 A 文章编号 1674-6805（2016）25-0010-03 　　【Abstract】 Objective：To discuss the clinical effect of retroperitoneal laparoscopic partial nephrectomy for the treatment of localized renal cell carcinoma.Method：44 patients with localized renal cell carcinoma underwent retroperitoneal laparoscopic partial nephrectomy in our hospital from January 2013 to July 2016 were analyzed retrospectively.Tumors were on the left side in 27 cases and on the right side in 17 cases.The tumor diameter of 1.0-5.1 cm，the average （2.8±1.3）cm.All patients underwent complete resection of tumor at the margin of 0.5-1.0 cm after laparoscopic surgery.Result：All the operations were completed successfully，without conversion to open surgery and no organ injury occurred.Operation time was 60-150 min，average （85.6±25.3）min，the warm ischemic time was 15-38 min，with an average （23.2±6.9）min，and estimated blood loss was 50-200 ml，average （110.3±45.8）ml.Postoperative urinary leakage in 1 case，1 case of renal hematoma，conservative treatment after recovery.Surgical resection margin was negative.The follow-up time was 1 to 42 months，average （20.5±5.3） months，all patients had no local recurrence and distant metastasis.Conclusion：Retroperitoneal laparoscopic partial nephrectomy is safe and feasible for the treatment of localized renal cell carcinoma，with less trauma and quicker recovery，meanwhile，renal function can be maximally reserved. 　　【Key words】 Renal cell carcinoma； Retroperitoneal laparoscopy； Partial nephrectomy 　　First-author’s a