CAJ | 학술논문

目的：探讨非阻断肾动脉腹腔镜肾部分切除术治疗T1a期肾癌的临床经验与治疗效果。方法回顾性分析我单位2008年6月至2012年6月期间收治的93例T1a期肾癌患者的临床资料，其中男性61例，女32例，肿瘤直径[2．9±0．5（1．0～3．9）]cm，肿瘤位于左肾43例，右肾50例。所有患者均行非阻断肾动脉腹腔镜肾部分切除术。记录手术时间、术中出血量、术后住院时间、术中及术后并发症、术后肾功能及术后恢复情况。结果所有手术均顺利完成，无中转开放手术者，手术时间[93±16（70～140）]分钟。术中出血[110±28（20～280）]ml，均未输血。术后住院时间[9．5±2．0（7～15）]天。术后病理报告切缘均为阴性。术前尿素氮及肌酐的均值分别为（5．0±0．7）mmol/L、（68．4±15．3）μmol/L；术后1周复查血尿素氮及肌酐均值分别为（5．6±0．8）mmol/L、（73．7±11．6）μmol/L（P＞0．05）。术中及术后无明显并发症。术后随访[37±4．5（12～60）]个月，患侧肾功能正常，肿瘤无复发及转移。结论非阻断肾动脉腹腔镜肾部分切除术治疗T1a肾肿瘤安全、有效，可将潜在的肾脏热缺血损伤降至最低。
목적：탐토비조단신동맥복강경신부분절제술치료T1a기신암적림상경험여치료효과。방법회고성분석아단위2008년6월지2012년6월기간수치적93례T1a기신암환자적림상자료，기중남성61례，녀32례，종류직경[2．9±0．5（1．0～3．9）]cm，종류위우좌신43례，우신50례。소유환자균행비조단신동맥복강경신부분절제술。기록수술시간、술중출혈량、술후주원시간、술중급술후병발증、술후신공능급술후회복정황。결과소유수술균순리완성，무중전개방수술자，수술시간[93±16（70～140）]분종。술중출혈[110±28（20～280）]ml，균미수혈。술후주원시간[9．5±2．0（7～15）]천。술후병리보고절연균위음성。술전뇨소담급기항적균치분별위（5．0±0．7）mmol/L、（68．4±15．3）μmol/L；술후1주복사혈뇨소담급기항균치분별위（5．6±0．8）mmol/L、（73．7±11．6）μmol/L（P＞0．05）。술중급술후무명현병발증。술후수방[37±4．5（12～60）]개월，환측신공능정상，종류무복발급전이。결론비조단신동맥복강경신부분절제술치료T1a신종류안전、유효，가장잠재적신장열결혈손상강지최저。
out clamping of renal artery. Operation time,blood loss,postoperative hospital stay,the incidence of complica-tions,preoperative and postoperative renal function were record and analyzed. Results All the 93 operations were completed successfully with no conversions. The mean operative duration was[93 ± 16(70 ~140)]min, mean estimated blood loss was [110 ± 28(20~280)]ml,mean postoperative hospital stay was [9. 5 ± 2. 0(7~15)]days. Preoperative creatinine and BUN were respectively (5. 0 ± 0. 7)mmol/L,(68. 4 ± 15. 3)μmol/L, and (5. 6 ± 0. 8)mmol/L,(73. 7 ± 11. 6)μmol/L(P>0. 05)1 week after operation. There were no significant complications during and after sugery. Postoperative pathology showed the incisal margin were negative. All pa-tients had normal renal function and had no tumor recurrence or metastasis during a mean follow-up time of [37 ± 4. 5(12 ~60)]months. Conclusions Laparoscopic partial nephrectomy for T1a renal cell carcinoma without clamping of renal artery is safe,effective and can minimize the potential renal injury caused by warm ischemia.