【作者】 范本祎； 齐琳； 齐范； 申鹏飞； 周密； 李卓；

【Author】 Ben-Yi Fan, Lin-Qi, Fan-Qi, Peng-fei Shen, Mi Zhou, Zhuo Li Department of Urology, Xiang-Ya Hospital of Central South University, Changsha 410008

【机构】 中南大学湘雅医院泌尿外科；

【摘要】 目的:解剖或者功能性孤肾肿瘤患者是行保留肾单位手术(NSS)的绝对适应症。术前辅助栓塞治疗(DSA)不但可减少术中出血,而且由于肿瘤与周围组织形成水肿带易于剥离,可提高肿瘤切除率,对有腔静脉癌栓形成者更具意义。本文旨探讨术前 DSA 栓塞在孤肾肿瘤患者保留肾单位手术治疗中的作用。方法:回顾性分析我院 2000-2005年共46例解剖或者功能性孤肾肿瘤患者DS介入栓塞后行保留肾单位手术切除肿瘤的临床及随访资料,以总结肾动脉栓塞术对保留肾单位的肾肿瘤手术的重要性。结果:46例患者中4例为解剖性孤独肾肿瘤患者;42例为功能性孤独肾肿瘤患者。手术前均行DSA栓塞治疗,栓塞后一周行保留肾单位手术全部获得成功。术后随访除2例失访,1例半年后死于脑血管意外,43例1～3年內均无局部复发和远处转移随访期间未出现肾功能衰竭而需透析治疗者。结论:对于需行保留肾单位手术治疗的孤肾肿瘤患者,手术前行 DSA 栓塞治疗有助于阻断肿瘤血供,减少术中出血, 缩短手术时间。而且肾动脉栓塞使肾肿瘤切除术相对变得安全、简便和省时,能提高手术切除率,减少肿瘤扩散转移机会。更多还原

【Abstract】 Objective: The patients who get the tumor in anatomic or functional single kidney have the absolute indication for the operationof nephron-sparing surgery(NSS). Using Digital subtracted angiography (DSA) before the operation can not only reduce bleeding, but also raise the proportion of tumor excision because the edema between the tumor and tissues makes tumor easy to dissection. It makes sense for the formation of cancer embolism in vena cava. Our purpose is to discuss the function of DSA before the operation of NSS with the tumor in single kidney. Methods: Retrospectively analyze the 46 cases of the tumor in anatomic or functional single kidney between the year 2000-2005 in our hospital who used DSA before the operation, and summarize the importance of DSA to the NSS. Result: In 46 cases, 4 are anatomic single kidney with tumor and 42 are functional. They all used DSA one week before the operation of NSS, and the operation were all succeed. Following up the patients, except 2 were lost and 1 was dead, other 43 patients in one to three years had no recurrence or metastasis. No one had kidney failure or need dialysis .Conclusion: For the one who gets the tumor in single kidney needs the operation of NSS,DSA before the operation can cut the blood of tumor and reduce the bleeding and time in operation. Kidney artery embolism makes it easy and safe to cut kidney tumor, and it can increase the rate of cutting, reducing the metastasis of tumor.更多还原