中央型与外周型肾肿瘤行腹腔镜保留肾单位手术的比较

发布时间：2018-09-14 09:44

【摘要】：目的:比较中央型与外周型肾肿瘤行腹腔镜保留肾单位手术的疗效。方法:回顾性分析2010-2014年笔者收治的153例肾肿瘤,其中术前CT检查证实为中央型肾肿瘤31例、外周型肾肿瘤122例,所有患者均行腹腔镜保留肾单位手术治疗。结果:所有手术均无中转根治或开放切除。中央型肾肿瘤组平均手术时间152.1 min,平均热缺血时间31.9 min,平均失血量46.8 m L,平均引流天数3.4 d,平均术后住院天数4.0 d,平均术后肌酐水平为1.03 mg/dl;外周型肾肿瘤组对应的数值分别为132.7 min、21.6 min、44.8 m L、3.0 d、4.3 d、1.02 mg/dl。两组患者在热缺血时间上比较差异有统计学意义,其余围术期指标差异均无统计学意义。结论:在有经验的泌尿外科中心,腹腔镜保留肾单位手术治疗中央型肾肿瘤可获得与外周型肾肿瘤同样的治疗效果。
[Abstract]:Objective: to compare the efficacy of laparoscopic nephron sparing surgery between central and peripheral renal tumors. Methods: a retrospective analysis was made on 153 cases of renal tumors admitted from 2010 to 2014. 31 cases of central renal tumors and 122 cases of peripheral renal tumors were confirmed by CT before operation. All the patients were treated with laparoscopic nephron sparing surgery. Results: no radical or open resection was found in all operations. The mean operation time of central renal tumor group was 152.1 min, the mean warm ischemic time was 31.9 min, the mean blood loss was 46.8 mL, the average drainage time was 3.4 days, the average postoperative hospitalization time was 4.0 days, and the mean postoperative creatinine level was 1.03 mg/dl; corresponding to peripheral renal tumor group. The values were 132.7 min,21.6 min,44.8 / L = 132.7 min,21.6 min,44.8 / L = 4.3dL / L = 4.3dg / L = 1.02 mg/dl., respectively. There was significant difference in warm ischemic time between the two groups, but there was no significant difference in other perioperative indexes. Conclusion: laparoscopic nephron-sparing surgery for central renal neoplasms can achieve the same therapeutic effect as peripheral renal tumors in an experienced urological center.
【作者单位】：北京大学第一医院泌尿外科北京大学泌尿外科研究所;
【分类号】：R737.11

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