【摘要】 虽然近年肾癌的发病率在上升,但是其5年生存率有较大的改善,得益于诊疗手段的进步。腹腔镜手术在泌尿外科的应用引发了肾癌治疗的革命性变化。尽管腹腔镜下肾部分切除术的适应证越来越宽,甚至已应用于体积大、内生型肿瘤的治疗,但是腹腔镜下肾切除术依然是体积大、高分期、中央型等肾癌首先考虑的方案之一。而腔镜手助、全腹腔镜下腔静脉瘤栓取出术也在开展当中。对于肾部分切除的缺血损伤的控制,主要从两方面来保护肾功能:降低肾温度、不阻断或选择性阻断肾动脉。此外单孔腹腔镜、经自然腔道腹腔镜等技术的出现也为肾癌的微创治疗提供了新的选择。腹腔镜技术与其他各种能量、影像平台的融合技术,针对特定的肾癌患者,较大地提高了手术的安全性和精确度。本文主要对上述腹腔镜手术治疗肾癌的进展作一综述。更多还原

【Abstract】 Despite the incidence of renal cell carcinoma(RCC) keeps rising in these years, the estimated 5-year relative survival rate of this cancer has improved by the progress of diagnostic and surgical techniques. Minimally invasive surgeries for RCC have gained widespread popularityand surpassed open techniques in daily work. Laparoscopic techniques have now been applied to both radical and partial nephrectomy procedures of varying complexity, even vena cavalthrombectomy. There are two techniques to decrease renal ischemia injury in laparoscopic partial nephrectomy,decreasing renal temperature and off-clamp or selective clamping renal artery. Additionally the laparoendoscopic single site and natural orifice transluminal endoscopic surgery have been applied to further minimize the trauma of operation. Application of various ablative procedures or imaging techniques can improve the safety andaccuracy of laparoscopict reatment of some selected RCC. We provide a review of the progress of these laparoscopic techniques in treating RCC.更多还原