论文部分内容阅读
目的:探讨经腹腔镜肾部分切除术治疗局限性肾细胞癌的手术技巧和近期疗效。方法:选择T1期、单发肿瘤,平均肿瘤直径4.0 cm(3.0~7.0 cm)的局限性肾细胞癌27例,术中用内镜bulldog钳阻断肾动脉;用剪刀或超声刀在距离肿瘤边缘0.5~1.0 cm处进行局部切除;肾切除床内置Surgicel薄片卷垫后,间断缝合肾实质,创面边缘喷涂FloSeal明胶基质以防延迟出血。术中冰冻确定切缘阴性。结果:27例手术均获成功,无术中、术后并发症。手术时间平均110 min;热缺血时间20~55 min,平均32 min;术中出血量平均150 mL。术后随访平均6个月,未见肿瘤局部复发,未见转移。结论:腹腔镜肾部分切除术治疗局限性肾细胞癌安全可靠,短期随访效果肯定。
Objective: To investigate the surgical technique and short-term curative effect of laparoscopic partial nephrectomy for the treatment of localized renal cell carcinoma. Methods: Twenty-seven patients with localized renal cell carcinoma of T1 grade, solitary tumor and average tumor diameter of 4.0 cm (3.0-7.0 cm) were selected. Intra-renal bulldog forceps were used to block the renal arteries. Scissors or ultrasound scalpel Local excision was performed at the margin of 0.5-1.0 cm. After the Surgicel lap was built in the nephrectomy bed, the renal parenchyma was intermittently sutured and the FloSeal gelatin matrix was sprayed on the edge of the wound to prevent delayed bleeding. Intraoperative frozen negative margin. Results: All 27 cases were successful without any intraoperative or postoperative complications. The average operation time was 110 minutes. The warm ischemic time was 20-55 minutes (average 32 minutes). The average amount of blood loss during operation was 150 mL. Follow-up average 6 months, no local tumor recurrence, no metastasis. Conclusion: Laparoscopic partial nephrectomy for the treatment of localized renal cell carcinoma is safe and reliable, with short-term follow-up effect.