CAJ | 학술논문

目的探讨后腹腔镜肾部分切除术治疗T1b期肾癌的临床疗效和安全性.方法回顾性分析14例T1b期肾癌患者的临床资料,均行后腹腔镜肾部分切除术;其中男11例,女3例,年龄(54.5±9.2)岁.左侧8例,右侧6例.肿瘤直径(5.1±1.3) cm.结果 14例手术经后腹腔镜均顺利完成,无中转开腹手术.手术时间(112.0±24.7) min,术中出血量(64.6±15.9) ml,术中热缺血时间(26.5±9.3) min.14例患者术中、术后均未输血.术后负压引流管放置时间(3.1±1.5)d,术后卧床72 h.术后12h肌酐升高1例,余患者术后未发现明显并发症.术后病理:14例患者手术切缘均为阴性,其中透明细胞癌13例,病理分期均为T1bN0M0;肾血管平滑肌脂肪瘤1例.术后随访3 ～16(21.4±9.6)个月,未见肿瘤局部复发以及远处转移,未见切口肿瘤种植.结论选择后腹腔镜下肾部分切除术治疗T1b期肾癌临床疗效确切,而且创伤小、恢复快,具有较好的临床应用前景.
목적 탐토후복강경신부분절제술치료T1b기신암적림상료효화안전성.방법 회고성분석14례T1b기신암환자적림상자료,균행후복강경신부분절제술;기중남11례,녀3례,년령(54.5±9.2)세.좌측8례,우측6례.종류직경(5.1±1.3) cm.결과 14례수술경후복강경균순리완성,무중전개복수술.수술시간(112.0±24.7) min,술중출혈량(64.6±15.9) ml,술중열결혈시간(26.5±9.3) min.14례환자술중、술후균미수혈.술후부압인류관방치시간(3.1±1.5)d,술후와상72 h.술후12h기항승고1례,여환자술후미발현명현병발증.술후병리:14례환자수술절연균위음성,기중투명세포암13례,병리분기균위T1bN0M0;신혈관평활기지방류1례.술후수방3 ～16(21.4±9.6)개월,미견종류국부복발이급원처전이,미견절구종류충식.결론 선택후복강경하신부분절제술치료T1b기신암림상료효학절,이차창상소、회복쾌,구유교호적림상응용전경.
Objective To evaluate the clinical effect and safety of retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal carcinoma.Methods Fourteen patients (11 males and 3 females) with T1b renal carcinoma were retrospectively performed.The age of patients was (54.5 ± 9.2)years old,with 8 cases on the left side and 6 cases on the right side.Tumor diameter was (5.1±1.3) cm.All the patients received retroperitoneal laparoscopic partial nephrectomy.Results None of the 14 cases was converted to open surgery.The operation time was (112.0 ± 24.7) min,the intraoperative blood loss was (64.6 ± 15.9) ml,the warm ischemia time was (26.5 ± 9.3) min.The 14 patients were not blood transfusion in intraoperative and postoperative.Postoperative negative pressure drainage placement time was (3.1 ± 1.5)d,lying in bed time was 72 h.Serum creatinine increase was found in 1 case postoperative 12 h,others were no severe complications.Postoperative pathology:the incisal margin of 14 cases were all negative,clear cell carcinoma was in 13 cases,the pathology stage was T1bNoM0;angiomyolipoma of kidney was in 1 case.All the patients were follow-up 3-16 (21.4 ± 9.6) months,all the patients had normal renal function and had no tumor recurrence or metastasis.Conclusion Retroperitoneal laparoscopic partial nephrectomy is safe and reliable for treatment of patients with T1b renal carcinoma.