·腹部疾病·
保留肾单位手术治疗肾错构瘤分析及体会(附12例报告)
作者:徐 磊1,2 姜书传1
所属单位:1.皖南医学院第一附属医院泌尿外科 (安徽 芜湖 241001) 2.安徽省芜湖市第二人民医院泌尿外科 (安徽 芜湖 241000)
PDF摘要
目的 探讨肾错构瘤的保留肾单位手术方法并总结临床经验。方法 对我院自2010年3月-2014年9月共12例行保肾 手术的肾错构瘤患者临床资料进行回顾性分析。结果 12例手术均获得成功,其中7例行后腹腔镜下肾错构瘤剜 除术,5例行开放肾错构瘤剜除术。手术时间75-210min,平均(122.9±39.2)min;热缺血时间15-40min,平均 (26.0±8.6)min;术中出血量30-650ml,平均(127.9±174.9)ml。术中输血1例。术后病理均证实为肾血管平滑肌 脂肪瘤。术后随访3-18个月,均无复发。结论 肾错构瘤剜除术手术效果确切,能最大限度保护肾功能,是一种安 全有效的手术方法。
Objective To discuss the methods of nephron-sparing surgery for treatment of renal hamartoma and summarize the clinical experience. Methods The clinical data of 12 cases of renal angeomyolipoma treated by nephron-sparing surgery from March 2010 to September 2014 were analyzed retrospectively. Results All prcedures were performed successfully ,7 cases were treated by retroperitoneal laparoscopic enucleation. 5cases were treated by open surgery of enucleation.Mean operation time was (122.9±39.2)min(from 75 min to 210 min), Mean warm ischemia time was (26.0±8.6)min(from 15 min to 40 min),Mean blood loss was (127.9±174.9)ml( from 30ml to 650ml).1case was received blood transfusion during the operation.All 12 cases of renal angiomyolipoma were confirmed by postoperative pathological test. None recurred during the follow-up from 3 to 18 months. Conclusions The effect of enucleation for treatment of renal hamartoma is exactly.This method can maximally protect ranal function and it is a safe and effective surgery.
【关键词】肾错构瘤;保留肾单位手术;剜除术
【中图分类号】R322.6+1
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2015.02.002
前言
肾错构瘤(renal hamartoma)是肾脏良性肿瘤, 临床多无症状,随着健康体检的普及,发病率逐年升 高,肾错构瘤较大时易并发破裂出血,严重可威及患 者生命。我科自2010年3月~2014年9月共对12例肾错 构瘤患者行保留肾单位手术,疗效满意,报告如下:例,右侧4例,双侧1例;其中肿瘤单发10例,多发 2例;瘤体最大径2.5~16cm,平均(5.6±3.7)cm; 无明显症状者10例,有腰部胀感者2例;所有患者均 行泌尿系B超检查发现肾实质内边界清晰的高回声团 块,大部分伴有声影。所有患者均行CTU或双肾CT增 强+IVP检查,CT扫描图像中均发现瘤体中部分组织呈 现负值,CTU及IVP均显示双输尿管通畅。所有患者术 前常规检查均排除手术禁忌症。
罕少疾病杂志
第22卷, 第 2 期
2019年11月
相关文章