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回顾肾癌的外科治疗历史,从传统的根治性肾切除术到保肾手术,再到腹腔镜、后腹腔镜、机器人辅助腹腔镜保肾手术,乃至近年来出现的腹腔镜、后腹腔镜肾肿瘤剜除术,从临床疗效上及肾功能的保护上取得了长足的进展。在微创保肾手术蓬勃发展的今天,腹腔镜、后腹腔镜下肾肿瘤剜除术获得了较好的肿瘤学效应,更好的保护了肾功能并降低了保肾手术中的并发症的发生率。但其在肾癌外科治疗中的应用仍有很大的争议。本文就肾肿瘤剜除术治疗肾癌的临床进展进行综述,并对肾肿瘤假包膜、肾肿瘤剜除术的预后、及保肾手术的切缘进行总结与讨论。
Review of the history of surgical treatment of renal cell carcinoma, from the traditional radical nephrectomy to kidney surgery, to laparoscopy, retro laparoscopy, robot assisted laparoscopic kidney surgery, and even in recent years, laparoscopic and retroperitoneal laparoscopic kidney Tumor surgery, from the clinical efficacy and protection of renal function has made considerable progress. In the vigorous development of minimally invasive kidney surgery today, laparoscopic and retroperitoneal laparoscopic nephrectomy has achieved good oncology, better protection of renal function and reduce the complications of kidney surgery Occurrence rate. However, its use in the surgical treatment of renal cell carcinoma remains controversial. This article reviews the clinical progress of nephrectomy in the treatment of renal cell carcinoma, and summarizes and discusses the prognosis of nephrectomy, nephrectomy and nephrectomy.