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目的探讨腹腔镜肾部分切除术治疗T1期肾门肿瘤的经验。方法回顾2004年6月至2013年6月腹腔镜肾部分切除术治疗12例T1期肾门肿瘤,肾门肿瘤定义为距离肾门血管或肾脏集合系统小于5 mm的肾肿瘤。其中左侧7例、右侧5例,平均年龄58岁(46~72岁),肿瘤直径平均3.6 cm(2.4~7 cm),观察临床疗效。结果全部患者顺利完成手术。平均手术时间80 min(50~140 min),平均热缺血时间28 min(18~45 min),术中平均出血量127 ml(50~340 ml)。术后迟发性出血2例,漏尿1例,术后住院时间平均7.2天(5~14天)。术后病理透明细胞癌8例,嫌色细胞癌2例,血管平滑肌脂肪瘤2例。随访5~48月,2例复发。全部患者术后肾功能正常。结论腹腔镜肾部分切除术治疗T1期肾门肿瘤可行,熟练的腹腔镜技术和术者的临床经验对于成功开展该治疗具有重要作用。
Objective To investigate the experience of laparoscopic partial nephrectomy in the treatment of T1 nephroureterectomy. Methods From June 2004 to June 2013, laparoscopic partial nephrectomy was performed in 12 patients with stage T1 nephroureterectomy. Renal neoplasms were defined as renal neoplasms less than 5 mm away from the nephronovascular or renal collecting system. The left side in 7 cases, the right side in 5 cases, the average age of 58 years (46 to 72 years), the average tumor diameter of 3.6 cm (2.4 ~ 7 cm), to observe the clinical efficacy. Results All patients successfully completed the operation. The average operation time was 80 min (50-140 min), mean warm ischemia time was 28 min (18-45 min), and mean intraoperative blood loss was 127 mL (50-340 mL). Postoperative delayed bleeding in 2 cases, 1 case of leaking urine, postoperative hospital stay an average of 7.2 days (5 to 14 days). Postoperative pathological clear cell carcinoma in 8 cases, chromophobe 2 cases, 2 cases of angiomyolipoma. Followed up for 5 ~ 48 months, 2 cases relapsed. All patients with normal renal function. Conclusion Laparoscopic partial nephrectomy for the treatment of T1 nephrourethral neoplasms is feasible and proficient in laparoscopic technique and the clinical experience of the surgeon plays an important role in the success of this treatment.