长期血透患者获得性囊性肾病合并肾癌8例报告并文献复习

陈恕求; 陈明; 张晓文; 柳靖; 胡向农; 杨瑜; 高明

长期血透患者获得性囊性肾病合并肾癌8例报告并文献复习

- 1 东南大学附属中大医院泌尿外科(南京, 210009);
- 2 东南大学附属中大医院肾脏内科

详细信息

通讯作者: 陈明,E-mail:chenshuqiu@hotmail.com

中图分类号: R737.11

收稿日期: 2011-08-17

Acquired cystic kidney disease associated renal cell carcinoma in long-term hemodialysis patients: report of 8 cases and review of literature

- 1. Department of Urology, Zhongda Hospital, Southeast University, NanJing, 210009, China;
- 2. Department of Nephrology, Zhongda Hospital, Southeast University

More Information

Corresponding author: CHEN Ming, E-mail: chenshuqiu@hotmail.com

Received Date: 17 August 2011

摘要

摘要: 目的:学习长期血透患者获得性囊性肾病合并肾癌的筛查和诊治方法。方法:回顾性分析我院维持性血透获得性囊性肾病合并肾癌患者8例,均为B超和CT诊断为双肾多发性囊肿合并肾实质性占位,并行后腹腔镜下根治性肾切除术,术后维持规律性血透,并严密随访。结果:长期血透患者226例,获得性囊性肾病105例(46.5%),获得性囊性肾病合并肾癌8例(3.5%),在获得性囊性肾病中发生率为7.6%(8/105),其中男5例,女3例,年龄(58.6±16.4)岁,血透(12.2±6.9)年。8例患者(9次)行后腹腔镜下根治性肾切除术,手术均成功,出血(45.2±20.3)ml,手术时间(72.5±20.3)min,无严重手术并发症,术后病理3例为透明细胞癌和6例为乳头状癌。住院天数为(7.5±2.4)d。随访12~63个月,无瘤存活5例。结论:肾癌在获得性囊性肾病患者中发病率高,随着血透患者寿命的延长,血透3年后需重视和建立肾癌筛查机制,腹腔镜下根治性肾切除术安全有效、恢复快,并注重患者心脑血管疾病及糖尿病等并发症的积极治疗,有助于进一步延长血透患者寿命。
- 肾癌 /
- 血透 /
- 获得性囊性肾病 /
- 筛查
Abstract: Objective:To summarize the screening,diagnosis and therapy of acquired cystic kidney disease(ACKD)associated renal cell carcinoma(RCC)in long-term hemodialysis patients.Method:Retrospective analysis 8 cases of ACKD associated RCC.All patients underwent abdominal ultrasound and CT scanning for hematuria or low back pain or periodical systemic screening.CT scanning showed multiple cystic in both kidneys and a tumor in one or two kidneys.8 patients underwent laparoscopic radical nephrectomy for renal tumor.Result:Total of 226 patients,including 105 cases of ACDK(46.5%),and RCC were detected in 8 cases of all patients(3.5%) and of 105 patients with ACDK (7.6%),1 of 8 patients was bilateral RCC.The RCC patients underwent hemodialysis for (12.2±6.9) years.5 cases of male and 3 cases of female,mean age (58.6±16.4) years.9 cases of RCC underwent laparoscopic radical nephrectomy successfully,and operative time was (72.5±20.3) minutes and the estimated blooding loss was (45.2±20.3) milliliters.9 cases of tumor confirmed clear cell carcinoma(3 cases)and papillary carcinoma(6 cases)by pathological examination.The mean hospital stay was (7.5±2.4) days.Follow-up ranged from 12 to 63 months.Five patients survived free of tumor recurrence.Conclusion:The incidence of RCC is higher in ACKD in long-term hemodialysis patients than in rest of the population,and with the prolonged lifetime of hemodialysis patients,it is important to pay attention to RCC screening of ＞3 years hemodialysis patients. Laparoscopic radical nephrectomy is safety for RCC patients with ACKD.
- hemodialysis /
- acquired cystic kidney disease /
- renal cell carcinoma /
- screening

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