保留肾单位手术治疗T1期肾癌的临床分析（附98例报告）

目的：探讨保留肾单位手术治疗T1期肾癌的临床疗效。方法：回顾性分析98例行保留肾单位手术治疗T1期肾癌患者的临床资料，其中男66例，女32例，平均年龄51岁（41～65岁）；对侧肾脏正常的患者85例，对侧肾脏存在疾患的患者13例；肿瘤平均直径2．4cm（1．3～6．5cm）；病理分期均为T1N0M0期；98例中93例行肾部分切除术，5例行肿瘤切除术。术后观察是否出现局部肾创面出血、漏尿等并发症，每3个月行腹部CT、肾脏ECT、超声及尿常规、肾功能检查。结果：98例手术均顺利完成，术后继发性出血3例、漏尿5例。随访10～12个月，平均10．3个月，2例术后6个月局部复发行根治性手术，其余96例无局部复发，无一例出现远处转移。结论：保留肾单位手术是治疗T1期肾癌安全有效的方法，值得推广。

Clinical Analysis of Nephron-sparing Surgery for T1 Stage Renal Cell Carcinoma(Report of 98 cases)

Objective：To explore the clinical effect of nephron-sparing surgery for T1 stage renal cell carcinoma. Methods：Retrospectively analyzed a total of 98 patients with T1 stage renal cell carcinoma treated with neph ron-sparing surgery. Of the 98 patients, 66 were male and 32 were female, with an average age of 51 years （41-65 years）. The 98 patients included 85 cases with unilateral tumor and normal contralateral kidney, 13 cases with unilateral tumor and a damaged opposite kidney. The mean tumor diameter was 2.4 cm （range 1.3to6.5 era）. The clinical stage was T1N0M0 in all patients. Among the 98 patients, 93 cases underwent partial nephreetomy and 5 underwent tumor enucleation. The complications were observed, such as secondary bleeding and urinary fistulas. During the follow-up, the examinations of abdominal CT, kidney ECT, ultrasound, urine test and serum creatinine were needed per 3 months. Results： The procedure was successful in all 98 patients. The postoperative complications included secondary bleeding （3 cases） and urinary fistulas（5 cases）. All patients were followed up for an average of 10.3 months （10 to 12 months）. During the follow-up period, 2 cases underwent radical nephrectomy because of local recurrence after 6 months and no distant metastasis were detected. Conclusions： Neph ron-sparing surgery for T1 stage renal cell carcinoma is a safe and effective procedure to be worthy of being extended.