Efficacy of retroperitoneal laparoscopic partial nephrectomy for T1b stage renal tumors(Report of 31 cases)
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摘要: 目的:总结T1b期肾肿瘤行后腹腔镜肾部分切除术的手术经验,探讨其安全性及疗效。方法:回顾性分析我院2009年4月~2014年3月行后腹腔镜肾部分切除术的31例T1b期肾肿瘤患者的临床资料,并与同期行后腹腔镜肾部分切除术的35例T1a期肾肿瘤患者的临床资料进行比较。结果:31例T1b期患者中,除1例因切缘阳性改行后腹腔镜根治术外,其余患者手术均获成功,无中转开放手术者。围手术期1例发生漏尿,无其它并发症发生。术后1个月肾功能均在正常范围内。结论:后腹腔镜肾部分切除术治疗T1b期肾癌是一种创伤小、安全可靠、疗效确切的手术方法,值得进一步研究和推广。
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关键词:
- 肾肿瘤 /
- 后腹腔镜肾部分切除术 /
- 疗效
Abstract: Objective:To introduce the experience and evaluate the safety and efficacy of retroperitoneal laparoscopic partial nephrectomy for patients with T1b stage renal tumors.Method:Thirty-one patients with T1b renal tumors underwent retroperitoneal laparoscopic partial nephrectomy in our department from April 2009 to March 2014. The clinical data were retrospectively analyzed and compared with 35 patients with T1a tumors undergoing the same surgery at the same time.Result:All patients with T1b tumors were operated successfully without conversion to open surgery, except one case was converted to radical nephrectomy because of positive margin. Perioperative complications included only one urine leakage. Postoperative renal function remained within the normal range one month postoperatively.Conclusion:Retroperitoneal laparoscopic partial nephrectomy is a feasible approach and can be safely performed for selected patients with T1b stage renal tumors.-
Key words:
- renal tumor /
- retroperitoneal laparoscopic partial nephrectomy /
- efficacy
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[1] 张旭, 朱庆国, 马鑫, 等. 后腹腔镜肾癌根治术的技术改进及临床效果(附30例报告)[J]. 临床泌尿外科杂志, 2002, 17(8): 402-404.
[2] Zhang X, Li H Z, Ma X, et al. Retroperitoneal laparoscopic nephron-sparing surgery for renal tumors: Report of 32 cases[J]. Urology, 2005, 65(6): 1080-1084, discussion 1084-1085.
[3] 朱捷, 高江平, 徐阿祥, 等. 无需打结的后腹腔镜保留肾单位肾部分切除术-介绍一种快速简单的腹腔镜缝合术[J]. 临床泌尿外科杂志, 2010, 25(5): 359-362.
[4] Ljungberg B, Cowan N C, Hanbury D C, et al. EAU guidelines on renal cell carcinoma: the 2010 update[J]. Eur Urol, 2010, 58(3): 398-406.
[5] Clayman R V, Kavoussi L R, Soper N J, et al. Laparoscopic nephrectomy: initial case report [J]. J Urol, 1991, 146(2): 278-282.
[6] Allan J D, Tolley D A, Kaouk J H, et al. Laparoscopic radical nephrectomy[J]. Eur Urol, 2001, 40(1): 17-23.
[7] Portis A J,Elnady M,Clayman R V.Laparoscopic radical/total nephrectomy: a decade of progress[J].J Endourol, 2001, 15(4): 345-54, discussion 375-376.
[8] Luo J H, Zhou F J, Xie D. Analysis of long-term survival in patients with localized renal cell carcinoma: laparoscopic versus open radical nephrectomy[J]. World J Urol, 2010, 28(3): 289-293.
[9] Permpongkosol S, Chan D Y, Link R E, et al. Long-term survival analysis after laparoscopic radical nephrectomy[J]. J Urol, 2005, 174(4 Pt 1): 1222-1225.
[10] Burgess N A, Koo B C, Calvert R C, et al. Randomized trial of laparoscopic v open nephrectomy[J]. J Endourol, 2007, 21(6): 610-613.
[11] Wright J L, Porter J R. Laparoscopic partial nephrectomy: comparison of transperitoneal and retroperitoneal approaches[J]. J Urol, 2005, 174(3): 841-845.
[12] Kieran K, Montgomery J S, Daignault S, et al. Comparison of intraoperative parameters and perioperative complications of retroperitoneal and transperitoneal approaches to laparoscopic partial nephrectomy: support for a retroperitoneal approach in selected patients[J]. J Endourol, 2007, 21(7): 754-759.
[13] Pattaras J G, Moore R G, Landman J, et al. Incidence of postoperative adhesion formation after transperitoneal genitourinary laparoscopic surgery[J]. Urology, 2002, 59(1): 37-41.
[14] McAllister M, Bhayani S B, Ong A, et al. Vena caval transection during retroperitoneoscopic nephrectomy: report of the complication and review of the literature[J]. J Urol, 2004, 172(1): 183-185.
[15] Fan X, Xu K, Lin T, et al. Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta-analysis[J]. BJU Int, 2013, 111(4): 611-621.
[16] Ren T, Liu Y, Zhao X, et al. Transperitoneal approach versus retroperitoneal approach: a meta-analysis of laparoscopic partial nephrectomy for renal cell carcinoma[J]. PLoS One, 2014, 9(3): e91978.
[17] Miller D C, Schonlau M, Litwin M S, et al. Renal and cardiovascular morbidity after partial or radical nephrectomy[J]. Cancer, 2008, 112(3): 511-520.
[18] Thompson R H, Boorjian S A, Lohse C M, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy[J]. J Urol, 2008;179(2):468-73.
[19] Capitanio U, Terrone C, Antonelli A, et al. Nephron-sparing Techniques Independently Decrease the Risk of Cardiovascular Events Relative to Radical Nephrectomy in Patients with a T1a-T1b Renal Mass and Normal Preoperative Renal Function[J/OL]. Eur Urol, 2014. pii: S0302-2838(14)00964-6.
[20] Dash A, Vickers A J, Schachter L R, et al. Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4-7 cm[J]. BJU Int, 2006, 97(5): 939-945.
[21] Leibovich B C, Blute M, Cheville J C, et al. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy[J]. J Urol, 2004, 171(3):1066-1070.
[22] Mitchell R E, Gilbert S M, Murphy A M, et al. Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger[J]. Urology, 2006; 67(2): 260-264.
[23] Deklaj T, Lifshitz D A, Shikanov S A, et al. Laparoscopic radical versus laparoscopic partial nephrectomy for clinical T1bN0M0 renal tumors: comparison of perioperative, pathological, and functional outcomes[J]. J Endourol, 2010, 24(10): 1603-1607.
[24] Simmons M N, Chung B I, Gill I S. Perioperative efficacy of laparoscopic partial nephrectomy for tumors larger than 4 cm[J]. Eur Urol, 2009, 55(1): 199-207.
[25] Nouralizadeh A, Simforoosh N, Tabibi A, et al. Laparoscopic partial nephrectomy for tumours >4 cm compared with smaller tumours: Perioperative results[J]. Int Urol Nephrol, 2011, 43(2): 371-376.
[26] Lifshitz D A, Shikanov S A, Deklaj T, et al. Laparoscopic partial nephrectomy for tumors larger than 4 cm: A comparative study[J]. J Endourol, 2010, 24(1): 49-55.
[27] Benway B M, Bhayani S B, Rogers C G, et al. Robot assisted partial nephrectomy versus laparoscopic partial nephrectomy for renal tumors: a multi-institutional analysis of perioperative outcomes[J]. J Urol, 2009, 182(3): 866-872.
[28] Jeong W, Park S Y, Lorenzo E I, et al. Laparoscopic partial nephrectomy versus robot-assisted laparoscopic partial nephrectomy[J]. J Endourol, 2009, 23(9): 1457-1460.
[29] Choi J D, Park J W, Lee H W, et al. A comparison of surgical and functional outcomes of robot-assisted versus pure laparoscopic partial nephrectomy[J]. JSLS, 2013, 17(2): 292-299.
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