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目的观察腹腔镜保留肾单位手术治疗T1期肾癌的效果。方法回顾性分析46例行腹腔镜保留肾单位手术治疗T1期肾癌患者的临床资料,其中经腹腔途径28例,经后腹腔途径18例,评估分析术后近期和远期并发症的发生情况。结果 46例手术均顺利完成,无中转开放,手术时间65～140min,热缺血时间16～38min,平均(24±0.8)min;术后继发性出血2例、漏尿2例、急性肾功能不全1例,淋巴管漏1例,平均随访24个月,2例术后1个月出现双肾总肾小球滤过率轻度下降,术后3个月恢复正常,46例患者均未出现局部复发及远处转移。结论腹腔镜保留肾单位手术治疗T1期肾癌安全、有效,具有较好临床应用价值。
Objective To observe the effect of laparoscopic nephron surgery on T1 stage renal cell carcinoma. Methods The clinical data of 46 patients with T1 stage renal cell carcinoma undergoing laparoscopic nephron surgery were retrospectively analyzed. Among them, 28 cases were treated by intraperitoneal approach and 18 cases were treated by retroperitoneal approach. The incidence of postoperative short-term and long-term complications was analyzed . Results All the 46 cases were successfully performed without transit. The operation time ranged from 65 to 140 minutes and the warm ischemia time ranged from 16 to 38 minutes (mean, 24 ± 0.8) min. Postoperative secondary bleeding occurred in 2 cases, leaking urine in 2 cases, acute kidney 1 case of dysfunction, 1 case of lymphatic leak, with an average follow-up of 24 months, 2 cases showed a slight decrease of total glomerular filtration rate in both kidneys 1 month after operation, returned to normal 3 months after operation, 46 cases were No local recurrence and distant metastasis. Conclusion Laparoscopic nephron-surgically preserved T1-stage renal cell carcinoma is safe and effective and has good clinical value.