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目的探讨后腹腔镜下肾癌根治术的效果。方法2001年10月～2006年9月,行后腹腔镜下肾癌根治术108例。肿瘤大小1.0～8.0cm,(4.3±2.9)cm。术前临床分期:T1N0M042例,T2N0M054例,T3aN0M012例。结果手术时间35～180min,(63.5±30.3)min。出血量20～1500ml,(75±23)ml。中转开腹3例。并发症包括术中下腔静脉或肾静脉损伤出血4例,切口感染3例,高碳酸血症8例。全组随访6～36个月,其中61例>12个月,2例术后1年肺部转移死亡,1例术后7个月肝转移死亡,其余105例均无瘤生存。1年生存率98.4%(60/61),3年生存率85.7%(18/21)。结论后腹腔镜下肾癌根治术切口小,恢复快,效果好,值得临床推广。
Objective To investigate the effect of laparoscopic radical nephrectomy. Methods From October 2001 to September 2006, 108 patients underwent laparoscopic radical nephrectomy. Tumor size 1.0 ~ 8.0cm, (4.3 ± 2.9) cm. Preoperative clinical stage: T1N0M042 cases, T2N0M054 cases, T3aN0M012 cases. Results The operation time was 35 ~ 180min, (63.5 ± 30.3) min. Bleeding volume 20 ~ 1500ml, (75 ± 23) ml. Transferred to open in 3 cases. Complications included intraoperative inferior vena cava or renal vein hemorrhage in 4 cases, incision infection in 3 cases and hypercapnia in 8 cases. The whole group was followed up for 6 to 36 months, of which 61 cases were> 12 months. Two patients died of pulmonary metastasis one year after operation, and one patient died of hepatic metastasis seven months after operation. The remaining 105 patients were tumor-free. The 1-year survival rate was 98.4% (60/61) and the 3-year survival rate was 85.7% (18/21). Conclusions Laparoscopic radical nephrectomy incision small, fast recovery, effective, worthy of clinical promotion.