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目的:探讨后腹腔镜技术治疗双侧肾癌的方法及疗效。方法:回顾性分析2004年1月～2010年6月11例双侧肾细胞癌患者的临床资料,同时型6例,异时型5例,肿瘤直径平均(2.8±1.8)cm。11例患者均分期行后腹腔镜手术治疗,其中8例行双侧肾部分切除术,3例行一侧肾癌根治及对侧肾部分切除术。结果:所有手术均顺利完成,无中转开放,平均手术时间(102±27)min,平均热缺血时间(23.0±7.7)min,术中平均出血量(80.0±43.5)ml,术后平均住院时间(10.6±2.0)d。术后平均随访(3.5±2.0)年,9例未见复发及转移且术后肾功能无异常,1例术后肌酐升高,1例肺转移予靶向药物治疗至今。结论:后腹腔镜技术治疗双侧肾癌安全、可行、有效,具有创伤小、恢复快的优点,但其远期疗效尚需大样本对照研究和长期随访观察。
Objective: To investigate the method and effect of retroperitoneal laparoscopy in the treatment of bilateral renal cell carcinoma. Methods: The clinical data of 11 patients with bilateral renal cell carcinoma from January 2004 to June 2010 were analyzed retrospectively. There were 6 patients with concurrent type and 5 patients with abnormal timing. The mean tumor diameter was (2.8 ± 1.8) cm. All the 11 patients underwent laparoscopic surgery after the staging. Among them, bilateral partial nephrectomy was performed in 8 cases, radical nephrectomy in 3 cases and partial nephrectomy in 3 cases. Results: All the operations were successfully completed. The average operation time (102 ± 27) min, mean warm ischemia time (23.0 ± 7.7) min, mean intraoperative blood loss (80.0 ± 43.5) ml and mean postoperative hospital stay Time (10.6 ± 2.0) d. After an average follow-up of 3.5 ± 2.0 years, no recurrence and metastasis were found in 9 cases and no abnormal renal function was observed. One case had postoperative creatinine elevation and one case had lung metastasis to target drug therapy. Conclusion: Retroperitoneal laparoscopy is a safe, feasible and effective method for the treatment of bilateral renal cell carcinoma. It has the advantages of small trauma and quick recovery. However, its long-term curative effect still needs large sample controlled study and long-term follow-up observation.