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目的探讨保留肾脏腹腔镜下手术治疗早期小肾癌。方法回顾性分析30例保留肾脏腹腔境下早期小肾癌切除术的临床资料。结果 30例患者均获得手术成功。手术时间75~125 min,平均105 min;肾动脉阻断的时间8~20 min,平均15 min;手术中失血150~300 ml,平均250 ml,术中未输血,术后1~3 d待肛门排气后正常进食,住院时间5~10 d,平均7 d。术后并发皮下气肿者3例,1周内自行吸收;未出现腹腔内迟发性出血、尿漏,术后检查肾功能均正常,无肾功能损害。病理诊断:18例为肾细胞癌(T1N0M0),12例为肾腺癌。术后检查血肾功能显示尿素氮及肌酐清除率均无明显变化。术后常规复查双肾CT平扫及增强扫描。术后给予患者常规免疫治疗。术后随访12个月,未发现肿瘤转移、复发。结论保留肾单位腹腔镜下肾肿瘤切除术治疗早期肾癌创伤小,手术显露满意,术后恢复快,安全有效。
Objective To investigate the effect of preserving renal laparoscopic surgery on early small renal cell carcinoma. Methods A retrospective analysis of 30 cases of retained renal peritoneal resection of early small renal cell carcinoma clinical data. Results 30 patients were successful in surgery. The operation time ranged from 75 to 125 minutes with an average of 105 minutes. The renal artery occlusion time ranged from 8 to 20 minutes with an average of 15 minutes. Blood loss was 150-300 ml during operation, with an average of 250 ml. Anal exhaust normal eating, hospitalization 5 ~ 10 d, an average of 7 d. Postoperative subcutaneous emphysema in 3 cases, 1 week self-absorption; no intra-abdominal delayed bleeding, urine leakage, postoperative renal function tests were normal, no renal impairment. Pathological diagnosis: 18 cases of renal cell carcinoma (T1N0M0), 12 cases of renal adenocarcinoma. Postoperative renal function tests showed no significant changes in urea nitrogen and creatinine clearance rate. Postoperative routine double renal CT scan and enhanced scan. Postoperative patients given conventional immunotherapy. After 12 months of follow-up, no tumor metastasis or recurrence was found. Conclusions Nephron sparing nephrectomy is a safe and effective method for the treatment of early renal cell carcinoma with small trauma and satisfactory operation.