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后腹腔镜下早期肾癌行肾部分切除术21例报告
郑军华1,彭波1,许云飞1,徐丹枫2,高轶2,崔心刚2
0
(1.同济大学附属第十人民医院泌尿外科,上海 200072; 2.第二军医大学长征医院泌尿外科,上海 200003)
摘要:
目的:探讨后腹腔镜对早期肾癌行肾部分切除术的方法和疗效。方法:2003年7月至2007年6月采用后腹腔镜技术使用超声刀、电凝钩对21例早期肾癌患者行保留肾单位手术,肿瘤平均直径(2.8±0.8) cm (1.5~4.5 cm)。其中肾透明细胞癌17例,肾颗粒细胞癌3例,嗜酸性细胞癌1例。结果:21 例均完成后腹腔镜保留肾单位手术,平均手术时间(105±15)min,平均出血量(120±22) ml,4例患者术中平均输血400 ml。1例发生尿漏,引流量200~300 ml,术后15 d负压吸引小于20 ml后拔出。术后住院时间平均(9±2) d (7~17 d)。随访时间3~48个月,平均(20±4)个月,肿瘤无复发。结论:腹腔镜肾部分切除术是可行的,也是安全的。
关键词:  肾肿瘤  肾部分切除术  腹腔镜外科手术
DOI:10.3724/SP.J.1008.2007.01050
基金项目:上海市科委基金(014119042, 054119604).
Retroperitoneal laparoscopic partial nephrectomy for early malignant renal tumors: a report of 21 cases
ZHENG Junhua1*,PENG Bo1,XU Yunfei1,XU Danfeng2, GAO Yi2,CUI Xingang2
(1.Department of Urology, The 10th People’s Hospital of Shanghai, Tongji University, Shanghai 200072, China; 2.Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai 200003)
Abstract:
Objective:To explore the procedures and clinical outcomes of retroperitoneal partial nephrectomy for early malignant renal tumors. Methods: A total of 21 patients (19 men and 2 women, with a mean age of 49 years) with early malignant renal tumors were subjected to retroperitoneal partial nephrectomy using ultrasound knife and electron microscopy. The 21 patients included 17 with clear cell renal carcinoma, 3 with granule cell renal carcinoma, and 1 with oxyphil cell renal carcinoma. The mean diameter of the tumors was (2.8±0.8) cm. Results: All the 21 cases underwent successful retroperitoneal partial nephrectomy without conversion to open operation. Mean surgical time was (105±15) min and mean blood loss was (120±22) ml. Four patients had a mean blood transfusion of 400 ml. One patient had urine leakage, with drainage volume of 200300 ml; the drainage was stopped 15 days after operation when the drainage was less than 20 ml. The mean postoperative hospital stay was (9±2) days (717 days). No patients had local recurrence during a mean follow up of (20±4) months. Conclusion: Laparoscopic partial nephrectomy is feasible and safe.
Key words:  kidney neoplasms  partial nephrectomy  laparoscopic surgical procedures