【摘要】 目的 探讨T_1a期肾细胞癌行腹腔镜下肾部分切除术的可行性及临床疗效。方法 选择83例T_1a期肾细胞癌患者行腹腔镜下肾部分切除术。肾动脉阻断,距肿瘤约0.5 cm处,整块剪除肿瘤和部分肾实质及其表面的脂肪组织,分层缝合集合系统和肾实质,解除肾动脉阻断。观察手术时间、肾动脉阻断时间、术中出血量、术后并发症、肾功能、临床复发及转移情况。结果 83例患者中2例因术中出血中转开放手术,其他病例均顺利完成腹腔镜手术。手术时间90～120 min,平均105 min;热缺血时间25～40 min,平均30 min;术中出血40～120 ml,均未输血。随访10～36个月,平均23个月,无继发出血,无漏尿,无肿瘤局部复发及远处转移,肾功能无异常。结论腹腔镜下肾部分切除术治疗T_1a期肾细胞癌安全可行。更多还原

【Abstract】 Objective To investigate the feasibility and clinical efficacy of laparoscopic partial nephrectomy for T_1arenal cell carcinoma.Methods 83 cases of T_1arenal cell carcinoma underwent laparoscopic partial nephrectomy.Renal artery occlusion,lifting from the tumor about 0.5 cm block cut off the fatty tissue of the tumor and part of the renal parenchyma its surface,layered suture collection system and renal parenchyma,renal artery occlusion.The operation time,blood loss,postoperative complications,renal function,clinical relapse and metastasis of renal artery occlusion were observed.Results Among the 83 cases,laparascopic operation was successfully performed in 81 cases except 2 cases,which were converted to open surgery due to blood loss during the lapaparscopic operation.The mean operation time was105 min（range,90-120 min）and the mean warm ischemia time was 30 min（range,25-40 min）.The blood loss was 40-120 ml,no blood transfusion.An average of 23 months of follow-up（range,10-36 months）showed no secondary bleeding,no leakage of urine,no local tumor recurrence and distant metastasis,and no abnormal renal function.Conclusion Laparoscopic partial nephrectomy surgery for T_1arenal cell carcinoma is feasible and safe.更多还原