Abstract：Objective:To evaluate the feasibility and efficacy of laparoscopic nephron-sparing surgery (LNSS) in treating renal tumor.Methods:We retrospectively analysed clinical data of 73 patients given LNSS between Mar 2010 and Mar 2012. Of the 73 cases, 49 were males, 24 females. The diameter of tumor was between 1.5 to 6.0 centimeter, the mean was 4.3 centimeter.Results:All surgeries were successfully taken. The mean last time was 65 minutes. The mean amount of bleeding was 30ml during the surgery. The mean warm ischemia time was 24 minutes. Resection range extented to 0.5 cm outside the border of tumor. Collection system damage was found in 7 patients and given repair. Pathological diagnosis showed angioleiomyolipoma in 12 patients, clear cell carcinoma in 55, chromophobe cell tumor in 4, papillary carcinoma in 2. All the pathological of the border of the tumor were negative. After surgery,the lasting time of retroperitoneal drainage tube was 7-9 days, and the catheter was 5-7 days. One patient had secondary bleeding after surgery and was given selective renal artery embolization. During 6-12 months follow-up, one patient had lung metastases and was given targeted therapy with sunitinib, no other patients had recurrence.Conclusions:LNSS was safe and effective in treating renal tumor with diameter less than 7 cm.
[1]Ari A, Ricardo L, Favaretto A,et al. Recovery of renal function after open and laparoscopic patial nephrectomy.Eur Urol,2010,58(4):596-601. [2]邢增术,肖亚军,赵军,等.后腹腔镜与开放手术行肾部分切除术治疗肾肿瘤的临床效果比较.临床泌尿外科杂志,2011,26(12):888-891. [3]Lau WKO, Blute ML, Weaver AL,et al.Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney.Mayo Clin Proc,2000,75(12):1236-1242. [4]Moinzadeh A, Gill IS, Finelli A, et al. Laparoscopic partial nephrectomy: 3-year followup. J Urol, 2006, 175(2):459-462. [5]Beri A, Lattouf JB, Deambros O, et al.Partial nephrectomy using renal artery perfusion for cold ischemia functional and oncologic outcomes. J Endourol,2008,22(6):1285-1290. [6]Gill IS,Abreu SC,Desai MM,et al.Laparoscopic ice slush renal hypothermia for partial nephrectomy:the initial experience.J Urol,2003,119(1):52-56. [7]周骏,梁朝朝,叶元平,等.腹膜后腹腔镜保留肾单位手术(附29例报告).腹腔镜外科杂志,2011,16(9):708-710.
