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目的探讨保留肾单位手术(NSS)治疗肾血管平滑肌脂肪瘤(RAML)的安全性及有效性。方法对56例采用NSS治疗的RAML患者的临床资料回顾性分析,其中肿瘤剜除术35例,肾部分切除21例,4例患者术前行选择性肾动脉栓塞术。结果术中切除肿瘤平均直径(5.6±2.7)cm,术中平均失血量(140±75)ml,术后无大出血、尿瘘。51例患者获得随访,平均随访36月(6～120月),术后肾功能相对稳定,未见肿瘤复发。结论保留肾单位手术是治疗RAML的较好方法,有效地控制出血和保护肾脏功能是手术成功的关键。
Objective To investigate the safety and efficacy of nephron sparing surgery (NSS) in the treatment of renal angiomyolipoma (RAML). Methods The clinical data of 56 patients with RAML treated with NSS were retrospectively analyzed. Tumor resection was performed in 35 cases and partial nephrectomy in 21 cases. Four patients underwent preoperative selective renal artery embolization. Results The average diameter of the tumor was (5.6 ± 2.7) cm and the mean intraoperative blood loss was (140 ± 75) ml. There was no major bleeding and fistula after operation. Fifty-one patients were followed up for an average of 36 months (range, 6 to 120 months). Postoperative renal function was relatively stable and no tumor recurrence was found. Conclusion It is a good method to treat the renal cell carcinoma with the preservation of nephron surgery. Effective control of hemorrhage and protection of renal function are the keys to successful operation.