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后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析
其他题名Retroperitoneal laparoscopic partial nephrectomy in patients with tumors larger than 4 cm
孟一森; 范宇; 李德润; 陈代晖; 王宇; 张骞; 周利群; 金杰
关键词腹腔镜 肾部分切除术 肾肿瘤 腹膜后 Laparoscopes Partial Nephrectomy Kidney Neoplasms Retroperitoneal
刊名中华泌尿外科杂志
2013
DOI10.3760/cma.j.issn.1000-6702.2013.11.001
34期:11页:805-809
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 评价后腹腔镜下肾部分切除术治疗直径>4 cm肾肿瘤的安全性和有效性.方法 回顾性分析2005年6月至2012年6月358例因肾细胞癌行后腹腔镜下肾部分切除术的患者资料.肾肿瘤直径0.7~7.9 cm,平均2.8 cm.根据肿瘤直径≤4.0 cm和>4.0 cm将患者分为两组,两组分别为307、51例.比较两组间术前临床指标(性别、年龄、肿瘤特征)、围手术期因素(手术时间、热缺血时间、出血量、住院时间)和术后早期并发症的差异. 结果 358例手术切缘均为阴性.肿瘤直径≤4.0 cm组和>4.0 cm组的肿瘤分级(P=0.017)、集合系统修复(34.9%和72.5%,P=0.000)、住院时间[(10.7±8.1)和(13.1±5.3)d,P=0.008]、术中并发症发生率(3.9%和13.7%,P=0.002)及术后早期并发症发生率(2.0%和13.7%,P=0.000)比较差异均有统计学意义,而热缺血时间[(23.9±11.1)和(25.7±11.7) min,P=0.288]差异无统计学意义. 结论 与≤4.0 cm的肾肿瘤相比,肿瘤直径>4.0 cm的后腹腔镜下肾部分切除术的并发症发生率增高、住院时间延长.但两组间热缺血时间和手术切缘差异无统计学意义.因此,对于单发的、肿瘤直径>4.0 cm的肾癌患者,术前影像学评估可行保留肾单位的肾部分切除术时,后腹腔镜下手术是一种可以选择的手术方式. Objective To compare the perioperative outcomes and early postoperative complications of retroperitoneal laparoscopic partial nephrectomy to treat renal cell carcinoma in patients with tumor >4.0 cm and those with tumor ≤4.0 cm.Methods Three hundred and fifty-eight patients who had undergone retroperitoneal laparoscopic partial nephrectomy for renal cell carcinoma from June 2005 to June 2012 were retrospectively analyzed.The mean diameter of the renal tumors was 2.8 cm (range 0.7-7.9 cm).The clinical factors (i.e.gender,age,tumor characteristics),perioperative course (i.e.,operative time,warm ischemia time,estimated blood loss,and length of hospitalization),and early postoperative complications were collected and compared between the patients with tumor burdens >4.0 cm compared with those with tumor burdens of ≤4.0 cm.Results All the patients' surgical margins were negative.Patients with larger tumors had significantly greater tumor grades (P =0.017),collecting system repairing (72.5% versus 34.9%,P=0.000),more intraoperative (13.7% versus 3.9%,P=0.002) and postoperative complications (13.7% versus 2.0%,P=0.000) and a significantly longer hospitalization (13.1±5.3 d versus 10.7±8.1 d,P=0.008).No other significant differences including warm ischemia time were noted between the 2 groups stratified by tumor size.Conclusion Retroperitoneal laparoscopic partial nephrectomy could be a feasible option for tumor burdens >4.0 cm to provide a nephron-sparing option for patients in whom lesions can be resected by individually assessed.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/45326
Collection北京大学第一临床医学院_泌尿外科
作者单位100034,北京大学第一医院泌尿外科 北京大学泌尿外科研究所
Recommended Citation
GB/T 7714
孟一森,范宇,李德润,等. 后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析[J]. 中华泌尿外科杂志,2013,34(11):805-809.
APA 孟一森.,范宇.,李德润.,陈代晖.,王宇.,...&金杰.(2013).后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析.中华泌尿外科杂志,34(11),805-809.
MLA 孟一森,et al."后腹腔镜下肾部分切除术治疗直径>4cm肾癌的临床分析".中华泌尿外科杂志 34.11(2013):805-809.
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