目的 探讨后腹腔镜手术Ⅰ期治疗双侧肾癌的可行性.方法 对2例双侧肾癌患者Ⅰ期施行后腹腔镜手术,一侧为后腹腔镜肾癌根治术,另一侧为后腹腔镜肾部分切除术.结果 2例手术均顺利完成,手术时间分别为6 h和4.5 h,术中肾段动脉阻断时间分别为25 min和18 min,术中失血量分别为600 mL和100 mL,术后住院时间分别为33 d和9 d.2例患者术后均出现血肌酐和尿素氮升高.其中1例患者术前即并发轻度肾功能不全,术后需要每周1~2次血液透析治疗.术后随访4~15个月,无肿瘤复发和转移.结论 针对合适的病例,后腹腔镜手术Ⅰ期可能治疗双侧肾癌是安全、有效、可行的.%Objective To explore the feasibility of one-period retroperitoneal laparoscopic surgery for bilateral renal cell carcinoma. Methods Two patients of bilateral renal cell carcinoma received one-period retroperitoneal laparoscopic operation including unilateral retroperitoneal laparoscopic nephron-sparing surgery and contralateral retroperitoneal laparoscopic radical nephrectomy. Results Retroperitoneal laparoscopic surgery was performed successfully in two cases without conversion to open surgery. Operative time was 6 hours and 4. 5 hours, respectively. Blocking time of renal artery branch was 25 minutes and 18 minutes, respectively. Blood loss was 600 mL and 100 mL respectively. Postoperative hospital stay was 33 days and 9 days, respectively. Renal function deteriorated slightly postoperatively, and one case with chronic renal failure preoperatively required hemodialysis regularly of one to two times per week. There were no tumor recurrence and metastasis in 4 to 33 months following up. Conclusion One period retroperitoneal laparoscopic surgery was safe, effective and feasible in treating patients with bilateral renal cell carcinoma which was minimally invasive, and had small blood loss, rapid recovery and a good short-term outcome.
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