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目的:探讨双肾同时性肾肿瘤的治疗方法。方法:回顾性分析26例双肾同时性肾肿瘤患者的临床资料。所有26例患者双侧均行经后腹腔镜手术切除肿瘤,手术分期进行,其中16例双侧肾肿瘤均行保留肾单位手术(NSS),10例一侧肾肿瘤行根治性肾切除术(RN),另一侧行NSS。26例患者随访18~85个月,中位随访59个月。结果:术后病理结果显示,20例双侧均为透明细胞癌,双侧乳头状细胞癌1例,双侧良性肿瘤2例,1例左肾透明细胞癌、右肾乳头状癌,1例右肾透明细胞癌、左肾嫌色细胞癌,1例左肾透明细胞癌、右肾为良性肿瘤。19例患者无瘤生存(73.1%),4例患者带瘤生存(15.4%),3例死亡(11.5%)。3年总体生存率为92.3%,3年无进展生存率为76.9%。结论:双肾同时性肿瘤的常见病理类型为透明细胞癌,手术方式应优先选择NSS,双侧手术应分期进行。靶向治疗辅助手术治疗,对于双肾同时性肾癌有着积极的意义。
Objective: To explore the treatment of renal renal tumors of both kidney types. Methods: A retrospective analysis of 26 cases of renal bi-renal tumors in patients with clinical data. All 26 patients underwent laparoscopic resection of the tumor on both sides, and the operation was performed in stages. Sixteen cases of bilateral renal tumors were treated with nephron sparing (NSS) and 10 cases of nephrectomy with radical nephrectomy (RN ), The other side of the line NSS. Twenty-six patients were followed up for 18-85 months with a median follow-up of 59 months. Results: The postoperative pathological findings showed that both of the 20 cases were clear cell carcinoma, 1 case of bilateral papillary carcinoma, 2 cases of bilateral benign tumor, 1 case of left renal clear cell carcinoma, right renal papillary carcinoma, 1 case Right renal clear cell carcinoma, left renal cell carcinoma, 1 case of left renal clear cell carcinoma, the right kidney is a benign tumor. Nineteen patients had tumor-free survival (73.1%), four patients had tumor-bearing survival (15.4%) and three patients died (11.5%). 3-year overall survival was 92.3%, 3-year progression-free survival rate was 76.9%. Conclusions: The common pathological type of simultaneous renal neoplasms is clear cell carcinoma. The surgical method should be given priority to NSS, bilateral surgery should be performed in phases. Targeted therapy adjuvant surgery for renal renal cell carcinoma has a positive meaning.