腹腔镜肾癌根治术治疗肾癌38例临床研究.docVIP

腹腔镜肾癌根治术治疗肾癌38例临床研究[摘要] 目的 探讨后腹腔镜肾癌根治术治疗局限性肾癌的手术方法及其临床疗效。方法 回顾性分析采用后腹腔镜肾癌根治术治疗的38例局限性肾癌患者的临床资料。结果 本组患者手术时间为100～180min，平均130min。术中出血40～350mL,平均90mL。无一例中转开放手术。术后住院7～11d，平均8.5d，术后肠道通气时间1～2d，大部分患者1天后可下床活动。术后2例Trocar放置部位伤口感染，经抗感染治疗后治愈；3例出现皮下气肿，术后自行吸收；术中术后未发现其它严重并发症。术后所有患者均获得随访，随访时间6～36个月，平均18个月。1例因肾癌肝转移，于术后1.5年死亡，其余病例经体检及影像学检查（超声波或CT检查）未发现局部复发或远处转移。结论 后腹腔镜肾癌根治术治疗局限性肾瘤具有微创，解剖清晰，术中出血少，术后恢复快等优点，值得临床推广。 [关键词]肾肿瘤； 根治术； 腹腔镜 [中图分类号] R736.6[文献标识码] B[文章编号] 1005-0515（2011）-02-029-01 [Abstract] Objective To study the surgical methods and clinical curative effect ofafter laparoscopic renal vesssed for the treatment of localized kidney. Methods A retrospective analysis is used after laparoscopic renal vesssed treatment of 38 cases of kidney cancer patients with clinical data of limitations. Results All patients operation time was 100～180min, average 130min. Intraoperatie bleeding 40～350mL, average 90mL. No case was transferred to open surgery. Postoperative hospitalization 7～11d, average 8.5d, postoperative intestinal ventilation time 1～2d, most patients 1 days can bed activities. Postoperative 2 cases Trocar placed parts, wound infection by anti-infection treatment cured after, Three cases with subcutaneous emphysema, postoperative itself absorption, Operative did not find other serious complications. All of the patients were obtained for postoperative follow-up time 6～36 months, an average of 18 months.1 case for liver, kidney cancer metastasis after 1.5 years died, the remaining cases of medical and imaging (ultrasonic or CT) not found local recurrence and distant metastasis. Conclusions After the treatment of localized laparoscopic renal tumors underwent kidney with minimally invasive, clear, intraoperatie bleeding and postoperative reactions less advantages, and clinical promotion. [Keywords]renal tumors； Vesssed； laparoscopic 肾癌是泌尿系统常见恶性肿瘤之一，肾癌根治性切除术是治疗肾癌的标准手术方法。自1991年Clayman[1]首次介绍后腹腔镜行肾切除以来，腹腔镜技术在泌尿外科领域得到了迅速发展。2000年1月～2009年12月，本院采用后腹腔镜肾癌根治术治疗局限性肾癌（localized ren