腹腔镜下保留肾单位肾部分切除术治疗肾癌临床分析.docVIP

腹腔镜下保留肾单位肾部分切除术治疗肾癌临床分析 　　摘 要 目的：探讨腹腔镜下保留肾单位肾部分切除术治疗肾癌的临床经验。方法：2009年7月到2011年08月，随访观察我院45例T1期肾癌患者行腹腔镜下保留肾单位肾部分切除术的疗效。结果：所有患者腹腔镜下保留肾单位肾部分切除术均成功完成，平均手术时间为108 min（80～190 min），肾动脉平均阻断时间为26 min（19～45 min），术中平均出血130 ml（30～400 ml），无一例输血，术后继发性出血1例，经对症治疗后好转。术后病理示透明细胞癌36例，乳头状细胞癌3例，嫌色细胞癌2例，颗粒细胞癌1例。术后随访4～28个月，未见肿瘤复发及转移。结论：腹腔镜下保留肾单位肾部分切除术治疗T1期肾癌安全有效。 　　关键词 肾肿瘤 腹腔镜术 肾部分切除术 　　中图分类号：R692.9 文献标识码：A 文章编号：1006-1533（2012）22-0035-03 　　Clinical analysis of retroperitoneal laparoscopic nephron sparing partial 　　nephrectomy for treatment of renal carcinoma 　　ZUO Li， ZOU Jian-gang， ZHOU Zhong-xing， WU Xiao-peng， LIU Wei-min， SU Tong， 　　CHEN Jin， JIANG Xiao-dong， WEI Gai-jie， LI Shou-chun， ZHANG Li-feng 　　（The Second People’s Hospital of Changzhou， Changzhou 213003， China ） 　　ABSTRACT Objective： To evaluate the clinical effect of retroperitoneal laparoscopic partial nephrectomy（RLPN） for the treatment of renal carcinoma. Method： From July 2009 to August 2011， 45 patients of T1 stage renal carcinoma who underwent retroperitoneal laparoscopic nephron sparing partial nephrectomy were followed up. Result： The operations were successfully completed. The average operative time was 108 minutes （ranged 80-190min）， the average clamping time was 26min （ranged 19-45min）， the intraoperative blood loss was 130ml （ranged 30-400ml）. No patient needed transfusion. The major post-operative complication was secondary bleeding in 1 case. Pathological examinations showed that 36 cases were clear cell carcinoma， 3 cases were papillary cell carcinoma， 2 cases were chromophobe cell carcinoma， and 1 case was granular cell carcinoma. No metastasis and recurrence were observed during follow-up period. Conclusion： Retroperitoneal laparoscopic partial nephretomy is a safe and effective method for the patients with T1 stage renal carcinoma. 　　KEY WORDS renal carcinoma； laparoscopy； partial nephrectomy 　　自从1993年Winfield等[1]报道了首例经腹腔镜肾部分切除术（laparoscopic partial nephrectomy， LPN），1年后Gill等[2]报道了首例腹膜后LPN以来， LPN在世界范围内迅速得到了推广，