摘要
目的分析评价肾部分切除手术（PN）治疗临床T1b期肾癌的安全性。方法回顾性分析2008年1月至2011年1月84例T1b期肾癌行肾部分切除术患者的临床资料，术前cT或MRI检查提示肿瘤最大直径4．2—7．0cm，平均4．9cm。统计分析手术时间、血流阻断时间、切缘阳性、术中出血量、肾功能变化、肿瘤复发情况等指标。结果84例手术均获成功，肾动脉阻断时间11—25min，平均14min。术中出血量30—200ml，中位70ml，无输血。常规病理提示肿瘤大小4．1～7．0cm，平均5．0em；手术切缘2—5mm，中位数3mm，切缘阴性。术后随访68～32个月，平均47个月，肾功能无变化，肿瘤无复发。结论肾部分切除术是治疗T1b期肾癌安全有效方法之一，肿瘤大小、肿瘤位置、肿瘤生长方式、肿瘤与肾门的位置关系是手术成功的重要相关因素。
Objective To analyze and evaluate the safety of partial nephrectomy（PN） for clinical T1b renal cell carcinoma. Methods From January 2008 to January 2011, a retrospective analysis was preformed for 84 patients with clinical T1b renal cell carcinoma underwent PN. The average maximal diameter was 4.9 cm（range 4. 2-7.0 crn） by CT scan or MRI. Operation time, warm ischemia time, safety margin, blood loss, renal function change and local recurrence were analyzed. Results Eighty-four operations were completed successfully. Median warm chemia was 14 min （range 11 to 25min）. Median blood loss was 70 ml （range 30- 200 min）, no transfusion needed. The mean tumor maximal diameter was 5.0 cm（range 4. 1 -7.0 cm）. The mean surgical margin was 3 ram（range 2-5 mm）, no tumor cells. The median follow-up was 47 months （range 68-32 months）, all the 84 patients survived without local recurrence. The serum creatinine levels after operation were the same as those before operation. Conclusions Partial nephrectomy （PN） is effective and safe for T1b renal cell carcinoma. Size, location, growth pattern, relation with the renal hilum are important related factors for successful operation.
出处
《中国实用医刊》
2014年第6期59-61,共3页
Chinese Journal of Practical Medicine
关键词
肾癌
肾部分切除术
手术切缘
肾功能
Renal cell carcinoma
Partial nephrectomy
Surgical margin
Renal function
