CAJ | 학술논문

目的：探讨低温原位肾灌注法在复杂肾肿瘤保留肾单位手术中的临床价值。方法2003年9月至2014年6月,我院采用低温原位肾灌注、保留肾单位手术治疗复杂肾肿瘤21例。其中中央型肾癌12例(含孤立肾1例,对侧肾萎缩2例,双肾多发肿瘤1例)；外周型肾癌2例；巨大肾血管平滑肌脂肪瘤6例；中央型肾嗜酸细胞瘤1例。术前介入下患侧肾动脉内留置球囊导管,术中阻断肾动脉,4℃灌注液原位肾灌注,行保留肾单位手术。结果21例患者均手术成功。术中肾动脉阻断时间16~34 min,平均21 min。出血量50~350 ml,平均113 ml。术中无并发症。术后3个月复查静脉肾盂造影,患肾均显影良好。结论低温原位肾灌注法在复杂肾肿瘤保留肾单位手术中安全、有效,具有重要临床价值。
목적：탐토저온원위신관주법재복잡신종류보류신단위수술중적림상개치。방법2003년9월지2014년6월,아원채용저온원위신관주、보류신단위수술치료복잡신종류21례。기중중앙형신암12례(함고립신1례,대측신위축2례,쌍신다발종류1례)；외주형신암2례；거대신혈관평활기지방류6례；중앙형신기산세포류1례。술전개입하환측신동맥내류치구낭도관,술중조단신동맥,4℃관주액원위신관주,행보류신단위수술。결과21례환자균수술성공。술중신동맥조단시간16~34 min,평균21 min。출혈량50~350 ml,평균113 ml。술중무병발증。술후3개월복사정맥신우조영,환신균현영량호。결론저온원위신관주법재복잡신종류보류신단위수술중안전、유효,구유중요림상개치。
Objective To discuss the clinical significance of nephron sparing surgery with renal hy-pothermia in situ for complex renal tumor. Methods From September 2003 to June 2014,nephron spar-ing surgery with renal hypothermia in situ was undertaken for 2 1 cases of complex renal tumor.Of the 2 1 patients,1 2 cases (including 1 case with solitary kidney,2 cases with contralateral renal atrophy,and 1 case with bilateral multiple renal tumor)had central renal cell carcinoma,and 2 cases had peripheral renal cell carcinoma.6 cases had huge renal angiomyolipomas,while 1 case had central renal oncocytoma.The balloon catheter was placed in the renal artery preoperatively.During the operation,we used the balloon catheter to block the renal artery,perfused the kidney with the 4 ℃ solution through the catheter,then the nephron sparing surgery was performed. Results Operation was successfully applied in all 21 cases. The renal artery occlusion time was 16-34 min (average 21 min).The blood loss during operation was 50-350 ml (average 113 ml).There was no complication during the operation.After 3 months of operation,intravenous pyelography was performed for all the patients and all the kidneys which had operation showed normal. Conclusions Nephron sparing surgery with renal hypothermia in si-tu is safe and effective,it is clinically important for complex renal tumor.