T1b期肾细胞癌保留肾单位手术的临床价值

Objective To investigate the safety and feasibility of T1b stage renal cell carcinoma (RCC) underwent nephron sparing surgery (NSS).Methods Fifty cases of T1b stage RCC treated with NSS through open、laparoscopic and robotic assisted laparoscopic resection in Zhongshan hospital from Jan.,2011 to Dec., 2013 were included and retrospectively analysized.Results Fifty patients were successfully performed through NSS with meas operation time of (122.8±44.1) min (70-210 min). Mean intra-operative blood loss of (196.6±212.8) mL (30-1 100 mL), mean preoperative serum creatinine of (77.4±22.0) μmol/L (42-150 μmol/L),and mean postoperative hospital stay of (8.4±6.5) days (5-46 days). In 38 cases with interruption of renal blood flow during operation, mean warm ischemia time was (29.0±8.5) min (20-47 min). The postoperative pathology indicated that 45 cases were clear cell carcinoma,3 cases were chromophobe renal cell carcinoma, 2 cases were papillary carcinoma.The 50 cases post-operation follow-up renal function, one week, three months and six months,the serum creatinine were (87.3±11.6) μmol/L, (82.5±10.8) μmol/L, (79.7±12.1) μmol/L; blood urea nitrogen were (5.7±1.6) mmol/L,(5.2±1.3) mmol/L and (5.1±1.2) mmol / L,respectively.It has no significant difference with the pre-operation. Conclusions Tumor resection and renal function blood urea nitrogen levels. partial preservation can be both achieved by NSS. Therefore it is an alternative treatment for T1b RCC, especially for those cases with solitary kidney or bilateral RCC.