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目的:探讨腹腔镜下保留肾单位肾部分切除术治疗肾癌的临床经验。方法:2009年7月到2011年08月,随访观察我院45例T1期肾癌患者行腹腔镜下保留肾单位肾部分切除术的疗效。结果:所有患者腹腔镜下保留肾单位肾部分切除术均成功完成,平均手术时间为108min(80～190min),肾动脉平均阻断时间为26min(19～45min),术中平均出血130ml(30～400ml),无一例输血,术后继发性出血1例,经对症治疗后好转。术后病理示透明细胞癌36例,乳头状细胞癌3例,嫌色细胞癌2例,颗粒细胞癌1例。术后随访4～28个月,未见肿瘤复发及转移。结论:腹腔镜下保留肾单位肾部分切除术治疗T1期肾癌安全有效。
Objective: To investigate the clinical experience of laparoscopic nephron partial nephrectomy for the treatment of renal cell carcinoma. Methods: From July 2009 to August 2011, 45 patients with T1 stage renal cell carcinoma in our hospital were followed up for laparoscopic nephron excision. Results: Laparoscopic nephron nephrectomy was successfully performed in all patients. The average operation time was 108 min (80-190 min), the average renal artery occlusion time was 26 min (19-45 min), the average intraoperative bleeding was 130 mL ~ 400ml), no case of transfusion, postoperative secondary hemorrhage in 1 case, after symptomatic treatment improved. Postoperative pathology showed 36 cases of clear cell carcinoma, 3 cases of papillary carcinoma, 2 cases of chromophobe and 1 case of granulosa cell carcinoma. All the patients were followed up for 4 to 28 months. No tumor recurrence and metastasis were found. Conclusion: Laparoscopic nephron nephrectomy for the treatment of T1 stage renal cell carcinoma is safe and effective.