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目的:探讨左肾癌并肾静脉瘤栓患者行经后腹腔途径全腹腔镜左肾癌根治术的可行性。方法:3例左肾癌伴左肾静脉瘤栓患者均在全麻下行经后腹腔全腹腔镜左肾癌根治术:术中放置4个穿刺套管针,游离腹主动脉和肾动脉后,用Hem-o-lok结扎切断肾动脉,于肾静脉近下腔静脉处用Hem-o-lok结扎切断肾静脉,完整切除肾脏及瘤栓。结果:3例手术均获得成功,术后恢复良好,5天出院。病理检查分别诊断为肾透明细胞癌2例,嫌色细胞癌1例。术后随访1～3个月.未见肿瘤复发和转移。结论:对选择性左肾癌并肾静脉瘤栓患者行经后腹腔全腹腔镜左肾癌根治术完全可行。
Objective: To investigate the feasibility of total laparoscopic radical nephrectomy in patients with left renal cell carcinoma and renal vein aneurysm thrombosis after transabdominal approach. Methods: Three patients with left renal cell carcinoma and left renal vein thrombosis underwent retroperitoneal laparoscopic radical nephrectomy under general anesthesia. Four punctured trocars were placed intraoperatively and the abdominal aorta and renal artery were dissociated. With Hem-o-lok ligation of the renal artery ligation, renal vein near the inferior vena cava Hem-o-lok ligation of the renal vein ligation, complete removal of the kidneys and tumor emboli. Results: All three cases were successful. The patients recovered well and were discharged after 5 days. Pathological examination were diagnosed as renal clear cell carcinoma in 2 cases, chromophobe carcinoma in 1 case. All the patients were followed up for 1 ~ 3 months. No tumor recurrence and metastasis were found. Conclusion: It is feasible to perform retroperitoneal laparoscopic radical nephrectomy in patients with selective left renal cell carcinoma and renal vein thrombus.