腹腔镜下多房囊性肾癌肾部分切除术的策略及随访（附17例报告）

doi:10.19558/j.cnki.10-1020/r.2019.02.002

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摘要 目的：探讨多房囊性肾细胞癌的临床特征和手术治疗策略,为临床诊治提供依据。方法：回顾性研究2013年3月–2018年3月华中科技大学同济医学院附属同济医院泌尿外科收治的17例多房囊性肾细胞癌患者资料。所有患者均行腹腔镜（或机器人辅助腹腔镜)下多房囊性肾细胞癌保留肾单位部分切除术,分析患者的临床表现及影像学特征、组织病理学特征、手术治疗及随访情况。结果：17例患者均行保留肾单位的肾部分切除术。术后病理检查均为多房囊性肾细胞癌。随访时间3~52个月,平均（35.0±13.7）个月。术后患者肾功能均正常,16例患者术后复查未见复发,临床症状消失;1例患者术后9个月行CT检查提示术后复发并再次行肾癌根治术及腹膜后脂肪淋巴结清扫,病理检查提示肾透明细胞癌伴腹膜后淋巴结转移。结论：多房囊性肾细胞癌患者多由体检发现,影像学表现相对特殊,需要慎重鉴别。手术治疗策略推荐经腹腔镜下保留肾单位部分切除术,具有创伤小,并发症少等优点,值得临床推广。

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	肖俊
	余淦
	杨春光
	胡恒龙
	王晶
	臧煜
	陈亮
	郭亮
	吴坚
	王少刚
	胡志全
	叶章群
	王志华

关键词 ：多房囊性肾细胞癌, 保留肾单位部分切除术, 影像学特征, 治疗效果

Abstract：Objective： To study the clinical features and surgical treatment strategies of multilocular cystic renal cell carcinoma and to provide the evidence for clinical diagnosis and treatment. Methods: The clinical manifestations, imaging features, histopathological features, surgical treatment and follows-up of 17 patients with multilocular cystic renal cell carcinoma undergoing laparoscopic (or robot-assisted laparoscopic) partial nephrectomy and admitted to the Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2013 to March 2018 were studied retrospectively. Results: The postoperative pathological examinations of all 17 patients undergoing partial nephrectomy confirmed the diagnosis of multilocular cystic renal cell carcinoma. The follow-up period was 3 to 52 months (mean 35.0±13.7 months). The renal function of the patients was normal after the operations. Sixteen patients had no recurrence and the clinical symptoms disappeared. One patient had a CT examination after 9 months, displaying the tumor was relapse at 9th months, and accepted radical nephrectomy and retroperitoneal lymph node dissection. Renal clear cell carcinoma with retroperitoneal lymph node metastasis was diagnosed pathologically. Conclusions: The multilocular cystic renal cell carcinoma is often identified by physical examination. The imaging findings are relatively special and need to be carefully distinguished. The laparoscopic partial nephrectomy can successfully complete the operation, with the advantages of more minimal invasion and less postoperative complications.

Key words： multilocular cystic renal cell carcinoma partial nephrectomy imaging features therapeutic effect

收稿日期: 2018-12-10

ZTFLH:

R737.11

通讯作者: 王志华,zhwang_hust@hotmail.com

引用本文:

肖俊, 余淦, 杨春光, 胡恒龙, 王晶, 臧煜, 陈亮, 郭亮, 吴坚, 王少刚, 胡志全, 叶章群, 王志华. 腹腔镜下多房囊性肾癌肾部分切除术的策略及随访（附17例报告）[J]. 微创泌尿外科杂志, 2019, 8(2): 79-83.
XIAO Jun, YU Gan, YANG Chunguang, HU Henglong, WANG Jing, ZANG Yu, CHEN Liang, GUO Liang, WU Jian, WANG Shaogang, HU Zhiquan, YE Zhangqun, WANG Zhihua. Treatment and follow-up of multilocular cystic renal cell carcinoma by laparoscopic nephron sparing surgery: A report of 17 cases. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(2): 79-83.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1485.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2019/V8/I2/79

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