目的：探讨后腹腔镜保留肾单位手术（ retroperitoneal laparoscopic partial nephrectomy，RLPN）治疗T1期肾癌的手术方法及临床效果。方法：回顾性分析37例行RLPN的T1期肾癌患者的临床资料，观察手术时间、术后住院时间、阻断方式及时间、术中出血和术后并发症及术后效果。结果：37例患者手术均顺利完成。手术时间62-185min，平均手术时间97min；肾动脉阻断时间0-47min，平均23.8min；出血量45-220ml，平均103.3ml；术中无并发症；术中切缘组织病理均阴性；术后无尿漏、继发出血及肾功不全发生；术后5天1例患者出现上消化道出血；平均住院日9天。随访时间3-48个月，平均24个月，复查B超及CT未见肿瘤复发及转移；复查静脉肾盂造影（ IVP）提示患侧肾肾功能良好。结论：RLPN安全有效、创伤较小、出血少、恢复快，同时可保留患肾功能，可作为治疗T1期肾癌的首选手术方式。%Objective:To evaluate the clinical experience of retroperitoneal laparoscopic partial nephrectomy ( RLPN)in the treatment of T1 renalcell carcinoma. Methods:RLPN was performed in 37 cases with T1 renalcell car-cinoma. Operation time,postoperative hospital staytime,the way and time of blocking,blood lose,postoperative compli-cations and effect were observed. Results:RLPN was performed in the 37 cases successfully. The meanoperation time was 97min(62-185min). The mean renal artery blood flow occlusiontime was 23. 8(0-47)min. The mean blood lose was 103. 3(45-220)ml. There was no intraoperative suigical complications. Intraoperative pathological margins were negative. There were no complications such as leakage of urine,secondary bleeding,renal insufficiency was oc-curred. 5 days after operation,1 patient had upper gastrointestinal bleeding. The mean hospital stay was 9d. During 24 (3-48)months of following up,there was no recurrence and metastasis,and no case was observed to have functional loss of the remaining kidney on intravenous urography. Conclusion:RLPN is safe,effective,mini-invasive,quicker recovery,meanwhile,renal function is maximally reserved,can be used as the preferred mode of operation treatment of stage T1 renal cell carcinoma.
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