Objective To evaluate the application of modified retroperitoneoscopic cytoreductive surgery in the treatment of metastatic renal cell carcinoma.Methods The operation method was improved from traditionally first treatmentof the kidney pedicle to the ureter.After the ureter was cut off,the renal pedicle and free kidney was treated from the lower to the upper along the layer without vessels.A total of 80 metastatic renal cell carcinoma patients underwent the above modified retroperitoneoscopic cytoreductive surgery from January to December 2016.Their clinical data were analyzed retrospectively.Results The mean operative time was (137.2 ± 36.4) min.The mean blood loss was (80.1 ±28.5) ml.The mean hospitalization stay after operation was (7.0 ± 2.3) days.There were 7 patients who needed open surgery.There were no postoperative complications.Conclusions During the modified retroperitoneoscopic cytoreductive surgery,the renal pedicle can be easily exposed.The surgery is safe and effective,with less complication,which can be useful in clinical setting.%目的 评价改良后腹腔镜减瘤术治疗转移性肾癌的临床应用价值.方法 手术方法由传统的先处理肾蒂改良为先处理输尿管,离断输尿管后,沿无血管层面由下极至上极方向,依次处理肾蒂和游离肾脏.回顾性分析2006年1月-2016年12月,80例应用改良后腹腔镜减瘤术治疗的转移性肾癌患者的临床资料,总结经验.结果 手术平均时间(137.2±36.4) min,平均出血量(80.1±28.5)ml,术后住院时间平均(7.0±2.3)天;其中7例改为开放手术,术后均无并发症发生.结论 改良后腹腔镜减瘤术具有容易暴露肾蒂、并发症较少和安全有效的特点,具有良好的临床应用价值,值得推广.
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