CAJ | 학술논문

六年内共收治肾母细胞瘤60例,其中38例在肿瘤切除后行腹膜后间隙广泛清扫术.分析此38例病理检查结果发现,Ⅰ期病例淋巴结阳性率为25%,肾上腺受侵率8.3%,肾周脂肪阳性率12.5%,肾静脉、微血管受侵均为4.16%.而且以上比率随病期进展而升高,提示肿瘤切除后行腹膜后间隙广泛清扫术的必要性.此外,对清扫术的解剖基础、手术方法及切除范围也作了介绍.
륙년내공수치신모세포류60례,기중38례재종류절제후행복막후간극엄범청소술.분석차38례병리검사결과발현,Ⅰ기병례림파결양성솔위25%,신상선수침솔8.3%,신주지방양성솔12.5%,신정맥、미혈관수침균위4.16%.이차이상비솔수병기진전이승고,제시종류절제후행복막후간극엄범청소술적필요성.차외,대청소술적해부기출、수술방법급절제범위야작료개소.
Nephrectomy for Nephroblastoma has been performed on 60 patients over a 6 years period since May,1986.On 38 patients in addition to nephrectomy,anextensive retroperitoneal dissection was performed,Group Ⅰ:the tumor in 24 patients was confined to the kidney and completely resected.Group Ⅱ:8 cases with local extension of the tumor were completely resected and Group Ⅲ:in 6 patients,the tumor was ruptured during or before surgery.Positive finding of local metastasis of tumor by microscopic examination of the excised specimen was proved in 11 patients of Group Ⅰ(45.8%),6 patients in Group Ⅱ(75%)and 6 in Group Ⅲ(100%).The local metastases were identified.The necessity and significance of retroperitoneal extensive dissection along with nephrectomy in the treatment of nephroblastoma are demonstrated in this study.There was no major complication or death in our series.The anatomy of retroperitoneal space and the technique of extensive dissection are also discussed.