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目的:探讨保留肾单位手术治疗肾癌的安全性和疗效。方法:对1993年2月～2006年10月共46例采用保留肾单位手术的肾癌患者的临床资料进行回顾性分析,其中双侧肾癌4例,孤立肾癌3例,对侧肾有病变或潜在功能受损的肾癌25例,对侧肾正常的肾癌14例。结果:46例患者术前均未发现转移灶。术后组织病理学结果示肾透明细胞癌36例,颗粒细胞癌6例,混合性细胞癌4例。术后42例(91%)获随访,随访时间6～160个月,平均随访65个月。5、10年生存率分别为94%、86%。3例术后出现局部复发和远处转移。结论:保留肾单位手术治疗肾癌安全有效,手术指征可扩展至对侧肾脏正常的患者。
Objective: To investigate the safety and efficacy of preserving nephron in the treatment of renal cell carcinoma. Methods: A retrospective analysis was performed on 46 cases of renal cell carcinoma patients who underwent nephron surgery from February 1993 to October 2006. There were 4 cases of bilateral renal cell carcinoma, 3 cases of isolated renal cell carcinoma, 3 cases of contralateral kidney 25 cases of renal cell carcinoma with lesions or potential impaired function and 14 cases of normal renal cell carcinoma of contralateral kidney. Results: All the 46 patients had no metastases before operation. Postoperative histopathological findings showed 36 cases of clear cell renal cell carcinoma, 6 cases of granulosa cell carcinoma and 4 cases of mixed cell carcinoma. Forty-two patients (91%) were followed up for 6 to 160 months with an average follow-up of 65 months. The 5-year and 10-year survival rates were 94% and 86% respectively. Three patients had local recurrence and distant metastasis. CONCLUSION: It is safe and effective to retain the nephron in the surgical treatment of renal cell carcinoma. The surgical indications can be extended to patients with normal contralateral kidneys.