CAJ | 학술논문

目的：探讨腹腔镜下冷冻消融治疗局限性肾癌的临床疗效。方法2003年1月～2009年1月我院采用经后腹膜腔途径腹腔镜下冷冻消融治疗12例局限性小肾癌。全麻下后腹腔镜探查暴露肿瘤，明确肿瘤位置并确定穿刺点，腹腔镜监视下穿刺针对肿瘤行穿刺活检送病理。将冷冻消融探针在超声图像的引导下缓慢穿刺直到肿瘤深部的边缘进行冷冻消融。结果手术时间60～85 min，平均65 min。术后住院3～7 d，平均4．5 d。术后3 d和3个月血清肌酐分别为（85．0±4.5）、（66．0±4．2）μmol／L。术后无出血和肠管、血管等器官损伤，无局部复发和转移。11例随访60～96个月，平均65个月，1例随访36个月后因冠心病合并急性广泛前壁心肌梗死死亡，其余11例均存活。结论腹腔镜下冷冻消融技术治疗局限性肾癌安全、有效。
목적：탐토복강경하냉동소융치료국한성신암적림상료효。방법2003년1월～2009년1월아원채용경후복막강도경복강경하냉동소융치료12례국한성소신암。전마하후복강경탐사폭로종류，명학종류위치병학정천자점，복강경감시하천자침대종류행천자활검송병리。장냉동소융탐침재초성도상적인도하완만천자직도종류심부적변연진행냉동소융。결과수술시간60～85 min，평균65 min。술후주원3～7 d，평균4．5 d。술후3 d화3개월혈청기항분별위（85．0±4.5）、（66．0±4．2）μmol／L。술후무출혈화장관、혈관등기관손상，무국부복발화전이。11례수방60～96개월，평균65개월，1례수방36개월후인관심병합병급성엄범전벽심기경사사망，기여11례균존활。결론복강경하냉동소융기술치료국한성신암안전、유효。
Objective To investigate the clinical effect of laparoscopic cryoablation for localized renal cell carcinoma . Methods A retrospective analysis of 12 cases of localized small renal cell carcinoma treated with retroperitoneal laparoscopic cryoablation from 2003 January to 2009 January in our hospital was carried out .Under general anesthesia , laparoscopic exploration was conducted after exposure of the tumor .The tumor location was clarified to determine the point of puncture .Under laparoscopic monitoring , a puncture needle was introduced into tumor for biopsy .Freeze ablation was conducted with cryoablation probe slowly entering into the deep edge of the tumor under the guidance of ultrasound imaging . Results The average operation time was 65 min (range, 60-85 min), the mean postoperative hospital stay was 4.5 days (range, 3-7 days), and the average serum creatinine at 3 days and 3 months after surgery were (85.0 ±4.5) μmol/L and (66.0 ±4.2) μmol/L, respectively.No postoperative bleeding or intestinal organ injury was noted .No local recurrence and metastasis happened .Eleven patients were followed up for 60-96 months (mean, 65 months), and 1 patient was followed up for 36 months when a coronary heart disease complicated with acute extensive anterior myocardial infarction occurred to death .The remaining 11 cases survived . Conclusion Laparoscopic cryoablation is a safe and effective minimally invasive treatment for localized renal cell carcinoma .