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目的探讨马蹄肾肾细胞癌(以下简称肾癌)的安全治疗方法。方法回顾性分析在同济大学附属第十人民医院接受治疗的5例马蹄肾肾癌患者的临床资料,肿瘤位于右侧肾脏1例、左侧肾脏4例,其中有2例患者的肿瘤累及峡部。总结各例患者的临床表现、诊断和治疗方法。结果5例患者经增强CT和增强MRI检查均获得及时准确的诊断,均行手术治疗。其中2例行后腹腔镜下根治性肾切除术,3例行经腹腔根治性肾切除术,均获得满意的疗效。结论根治性肾切除术是马蹄肾肾癌的首选治疗方案,血管解剖变异的术前评估和术中峡部处理是手术成功的关键,位于肾脏中上极、较小、肾动脉分支不多的肿瘤也可行后腹腔镜下根治性肾切除术。
Objective To investigate the safe treatment of horseshoe kidney and renal cell carcinoma (hereinafter referred to as kidney cancer). Methods The clinical data of 5 cases of horseshide kidney and kidney cancer who were treated in Tenth People’s Hospital affiliated to Tongji University were analyzed retrospectively. The tumors were located in the right kidney in 1 case and the left kidney in 4 cases. The tumor in 2 cases involved the isthmus. Summary of each patient’s clinical manifestations, diagnosis and treatment. Results All the 5 patients were diagnosed in time and accurately by enhanced CT and enhanced MRI. Surgical treatment was performed. Among them, 2 cases underwent laparoscopic radical nephrectomy and 3 cases underwent radical nephrectomy, all of which achieved satisfactory results. Conclusions Radical nephrectomy is the first choice for the treatment of horseshide kidney and renal cell carcinoma. Preoperative evaluation of vascular anatomical variation and intraoperative isthmus treatment are the keys to successful operation. The neoplasms located in the upper pole and the smaller kidney with few branched renal arteries Retroperitoneal laparoscopic radical nephrectomy is also feasible.