后腹腔镜肾部分切除术在中度及高度复杂性肾脏肿瘤中的应用

发布时间：2018-03-23 22:23

本文选题：后腹腔镜　切入点：肾部分切除术　出处：《首都医科大学》2014年硕士论文

【摘要】：目的：探讨中度及高度复杂性肾脏肿瘤行后腹腔镜肾部分切除术的有效性和安全性。方法：对2005年12月到2013年12月49例中度复杂性和7例高度复杂性肾脏肿瘤患者的临床资料进行回顾性分析，患者的平均年龄为53.20±14.51岁；平均BMI为24.57±3.50；肿瘤直径平均为4.02±1.27cm；平均R.E.N.A.L评分为8.29±1.04；其中31例的肿瘤位于腹前侧，而另外25例位于腹后侧。本组56例患者均经后腹腔镜肾部分切除术完成肾脏肿瘤的治疗。结果：56例患者均取得了手术的成功，无术中中转开放病例，无术中输血病例，并且罕见严重手术并发症。手术用时142.68±47.51min；热缺血时间28.54±6.40min；失血量175.71±160.06ml；住院时间16.68±4.74天；术后并发症包括尿漏、发热、肺部感染等，经对症治疗均好转。因术后血红蛋白值快速下降而行输血治疗1例。严重并发症发生在一例女性患者，该患者术后3天出现大量严重的血尿，，遂急诊行开放患肾切除术。结论：中度及高度复杂性肾脏肿瘤经后腹腔镜肾部分切除术治疗安全、有效，但其疗效是不是优于腹腔镜根治性肾切除术还需长时间的随访研究。
[Abstract]:Objective: to evaluate the efficacy and safety of retroperitoneal laparoscopic partial nephrectomy for moderate and high complex renal tumors. Methods: the clinical data of 49 patients with moderate complexity and 7 patients with high complexity renal tumor from December 2005 to December 2013 were retrospectively analyzed. The average age of the patients was 53.20 卤14.51 years old. The mean BMI was 24.57 卤3.50, the average diameter of tumor was 4.02 卤1.27 cm, and the average R.E.N.A.L score was 8.29 卤1.04.The tumors of 31 cases were located at the anterior side of the abdomen, while the other 25 cases were located at the posterior side of the abdomen. All the 56 cases were treated with retroperitoneal laparoscopic partial nephrectomy. Results the operation was successful in 56 cases. There were no cases of intraoperative conversion, no cases of intraoperative blood transfusion, and rare severe complications. The operative time was 142.68 卤47.51 min, the warm ischemic time was 28.54 卤6.40 min, the blood loss was 175.71 卤160.06 ml, and the hospitalization time was 16.68 卤4.74 days. Postoperative complications include urinary leakage, fever, pulmonary infection, etc. They were all improved by symptomatic treatment. Blood transfusion was performed in 1 case because of the rapid decrease in hemoglobin value after operation. Serious complications occurred in a female patient. The patient developed severe hematuria 3 days after operation and underwent open nephrectomy. Conclusion: retroperitoneal laparoscopic partial nephrectomy is safe and effective in the treatment of moderate and highly complex renal neoplasms, but whether the curative effect is better than that of laparoscopic radical nephrectomy still needs a long follow-up study.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.11

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