腹腔镜下保留肾单位手术61例疗效评价

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摘要目的:探讨腹腔镜下肾部分切除术治疗早期肾肿瘤的方法及疗效。方法:2004年5月至今,实施腹腔镜下肾部分切除术61例, 其中50例采用后腹腔镜下肾部分切除(肾动脉主干阻断),11例采用后腹腔镜下节段性肾动脉阻断肾部分切除术。结果:61例手术均成功,手术时间:65~190 min,平均110 min;术中出血量30~620 ml;本组1例出现漏尿,输尿管置入双J管后痊愈;1例术后继发出血,栓塞治疗痊愈。术后随访1~48个月,所有患者情况良好,未见肿瘤复发或远处转移。结论:临床分期T_1a及部分T_1b期、单发的肾肿瘤采用腹腔镜下肾部分切除是安全、可行、有效的,且采用腹腔镜下节段性肾动脉阻断肾部分切除能有效的保护肾功能。

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	钱彪
	王勤章
	丁国富
	李应龙
	倪钊
	王新敏
	李强
	王江平
	王文晓

关键词 ：肾肿瘤, 腹腔镜, 肾部分切除术, 节段性肾动脉阻断

Abstract：Objective:To summarize the surgical technique and therapeutic effect of laparoscopic nephron-sparing surgery for renal tumors.Methods:Between May 2004 and August 2012, nephron sparing surgery was performed in 61 cases.50 patients with renal tumors were treated with retroperitoneal laparoscopic nephron-sparingsurgery(renal artery clamping),and the other 11 patients received retroperitoneal laparoscopic.Results:All procedures were technically successful in the thirty-three patients.The mean operative time was 110 min (65-190 min) and the blood loss during operation was 620 ml(30-600 ml).No postoperative complications occurred.Neither local recurrence nor metastasis was observed during a follow-up of 1-48 months.Conclusions:Laparoscopic nephron-sparing surgery is safe and effective for renal neoplasms.

Key words： renal tumor laparoscopic nephron-sparing surgery renal segmental artery clamping

收稿日期: 2012-09-04

ZTFLH:

R737.2

基金资助:兵团杰出青年专项基金(2011CD002)

通讯作者: 王勤章 wqz1969@sina.com

引用本文:

钱彪, 王勤章, 丁国富, 李应龙, 倪钊, 王新敏, 李强, 王江平, 王文晓. 腹腔镜下保留肾单位手术61例疗效评价[J]. 微创泌尿外科杂志, 2012, 1(1): 56-58.
Qian Biao, Wang Qingzhang, Ding Guofu, Li Yinglong, Ni Zhao, Wang Xinmin, Xie Shunming, Wang Jiangping, Wang Wenxiao. The clinical analysis of laparoscopic nephron-sparing surgery for renal tumors(Report of 61 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2012, 1(1): 56-58.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract966.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2012/V1/I1/56

[1]Berger A,Crouzet S,Canes D,et al.Minimally invasive nephron-sparing surgery. Curr Opin Urol,2008,18(5):462-466.
[2]Ljungberg BJ, Jacobsen J, Rudolfsson SH,et al.Different vascular endothelial growth factor (VEGF), VEGF-receptor 1 and -2 mRNA expression profiles between clear cell and papillary renal cell carcinoma.BJU Int, 2006,98(3):661-667.
[3]Yildiz E, Ayan S, Goze F, et al. Relation of microvessel density with microvascular invasion, metastasis and prognosis in renal cell carcinoma. BJU Int, 2008, 101(6):758-764.
[4]Djordjevic G, Mozetic V, Mozetic DV,et al.Prognostic significance of vascular endothelial growth factor expression in clear cell renal cell carcinoma.Pathol Res Pract, 2007,203(2):99-106.
[5]DorevicG, Matusan-Ilijas K, BabarovicE,et al. Hypoxia inducible factor-1alpha correlates with vascular endothelial growth factor A and C indicating worse prognosis in clear cell renal cell carcinoma.J Exp Clin Cancer Res, 2009, 28(1):40.
[6]Fogarty JD, Hafron JM, Hoenig DM, et al. Laparoscopic nephron-sparing surgery for the small exophytic renal mass. JSLS, 2005, 9(2):199-204.
[7]Leibovich BC, Blute ML, Chebille JC, et al. Neohron sparing surgery for appropriately seleted renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol, 2004,171(3):1066-1070.
[8]Porpiglia F, Renard J, Billia M, et al. Is renal warm ischemia over 30 minutes during laparoscopic partial nephrectomy possible? One-year results of a prospective study. Eur Urol, 2007,52(4):1170-1178.
[9]Thompson RH,Blute ML. At what point does warm ischemia cause permanent renal damage during partial nephrectomy? Eur Urol, 2007, 52:961-963.
[10]Becker F, Van Poppel H, Hakenberg OW, et al. Assessing the impact of ischaemia time during partial nephrectomy.Eur Urol, 2009, 56(4):625-634.
[11]Kobayashi Y, Usui Y, Shima M, et al. Evaluation of renal function after laparoscopic partial nephrectomy with renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine. Int J Urol, 2006, 13(11):1371-1374.
[12]Nohara T, Fujita H, Yamamoto K, et al. Modified anatrophic partial nephrectomy with selective renal segmental artery clamping to preserve renal function: a preliminary report. Int J Urol, 2008, 15(11):961-966.