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目的:探讨后腹腔镜保留肾单位手术(NSS)治疗T1b期肾癌(RCC)的手术方法及临床疗效。方法:2009年2月~2012年2月,对5例临床分期为T1b期RCC患者行后腹腔镜NSS,其中男3例,女2例,平均年龄(55.4±9.6)岁,左侧3例,右侧2例。肿瘤平均直径(5.7±1.3)cm。结果:所有手术均顺利完成,无中转开放,围手术期无严重并发症。平均手术时间(110.0±29.5)min,术中平均热缺血时间(24.2±5.1)min,术中平均出血量(42.2±13.1)ml,术后尿漏1例;术后平均住院时间(5.9±2.1)d,术后平均随访(25.3±11.1)个月,全部患者肾功能正常且未见肿瘤局部复发及远处转移。结论:后腹腔镜NSS治疗T1b期RCC创伤小、出血少、并发症少且近期疗效满意;但其远期疗效还需大样本对照研究和长期随访观察。
Objective: To investigate the surgical methods and clinical effects of retroperitoneal laparoscopic nephron sparing surgery (NSS) in the treatment of T1b renal cell carcinoma (RCC). Methods: From February 2009 to February 2012, 5 cases of RCC with T1b stage were enrolled in this study. There were 3 males and 2 females with a mean age of (55.4 ± 9.6) years old and 3 left cases , Right in 2 cases. The average tumor diameter (5.7 ± 1.3) cm. Results: All the operations were successfully completed, no transfer to open, no serious perioperative complications. The mean operative time (110.0 ± 29.5) min, mean intraoperative warm ischemia (24.2 ± 5.1) min, mean intraoperative blood loss (42.2 ± 13.1) ml and postoperative urinary leakage were 1. The average postoperative hospital stay (5.9 ± 2.1) d. All cases were followed up for an average of (25.3 ± 11.1) months. All patients had normal renal function and no local tumor recurrence and distant metastasis. Conclusions: Retroperitoneal laparoscopic NSS has the advantages of less trauma, less bleeding, fewer complications and short-term curative effect in T1b stage. However, its long-term efficacy needs large sample controlled study and long-term follow-up observation.