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目的:分析一种新的肾部分切除术外科技术治疗肾门前后唇巨大肿瘤的可行性,有效性和安全性。方法:2013年6月~2014年11月对18例肾门前后唇巨大肿瘤患者运用一种新的肾部分切除外科技术进行治疗。观察记录并分析手术时间、术中出血量、温缺血时间、围手术期严重并发症的发生情况、术后恶性肿瘤切缘阳性的情况、住院日、术后3~12个月术侧肾功能及肿瘤复发情况等。结果:18例手术无中转开腹手术。平均手术时间150min。平均温缺血时间25min。平均术中出血120ml,术中修补肾静脉破损1例。围手术期无出血、尿瘘等严重并发症。病理提示15例肾细胞癌,切缘均为阴性;3例肾血管平滑肌脂肪瘤。平均住院8d。术后6~12个月随访无一例放射学复发,术侧肾小球滤过率上升小于8ml/min。结论:新的肾部分切除外科技术治疗肾门肿瘤是可行、安全和有效的。
OBJECTIVE: To analyze the feasibility, efficacy and safety of a new partial nephrectomy surgical technique for the treatment of giant tumor of the lip in front and back of the kidney. METHODS: From June 2013 to November 2014, 18 patients with giant tumor of the anterior and posterior lip of the kidney were treated with a new partial nephrectomy technique. Observation and record of operation time, intraoperative blood loss, warm ischemia time, perioperative complications, the positive margins of malignant tumors after surgery, hospitalization days, 3 to 12 months after surgery, Function and tumor recurrence and so on. Results: 18 cases of surgery without transit laparotomy. The average operation time 150min. The average warm ischemia time 25min. The average intraoperative bleeding 120ml, intraoperative repair of renal vein injury in 1 case. Perioperative bleeding, urinary fistula and other serious complications. Pathology prompted 15 cases of renal cell carcinoma, the margin was negative; 3 cases of renal angiomyolipoma. The average hospitalization 8d. No recurrence was found in 6 to 12 months after operation, and the rate of glomerular filtration rate increased less than 8ml / min. Conclusion: The new partial nephrectomy surgical treatment of renal tumors is feasible, safe and effective.