本文選題：局限性腎癌　切入點(diǎn)：保留腎單位手術(shù)　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的分析及比較保留腎單位手術(shù)(nephron sparing surgery, NSS)與根治性腎切除術(shù)(radical nephrectomy, RN)治療局限性腎癌的臨床療效。 方法回顧性分析我科從2008年1月至2013年12月行NSS或RN治療的180例患者的病例資料,患者的生存結(jié)局(轉(zhuǎn)移、復(fù)發(fā)及死亡與否)通過(guò)查閱影像資料、病歷和電話(huà)隨訪(fǎng)獲得,最終137例腎癌患者獲得隨訪(fǎng)(3.-.72個(gè)月,中位隨訪(fǎng)時(shí)間29個(gè)月),其中行NSS32例,RN為105例。對(duì)比分析兩組共137例患者的年齡、性別、術(shù)前臨床表現(xiàn)、腫瘤大小、術(shù)后TNM分期、并發(fā)癥發(fā)生率,并用Kaplan-Meier法對(duì)兩組的總生存率、腫瘤特異性生存率、無(wú)疾病進(jìn)展生存率等作生存分析。 結(jié)果兩組均順利完成手術(shù),對(duì)于51例≤4cm的腎癌患者,NSS組(n=27)的3年、5年的腫瘤特異性生存率均為100%；RN組(n=24)的3年、5年的腫瘤特異性生存率都為92.9%,兩組整體比較無(wú)統(tǒng)計(jì)學(xué)差異(P=0.398)。而對(duì)于137例腎癌患者,兩組的3年和5年的總生存率、腫瘤特異性生存率、無(wú)疾病進(jìn)展生存率比較均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。 結(jié)論對(duì)于臨床分期為pTla甚至pT1b期的腎癌患者,NSS能最大限度保留腎單位,避免發(fā)生術(shù)后腎衰竭的可能,且控制腫瘤的遠(yuǎn)期療效與RN相當(dāng),是一種安全、有效的術(shù)式。
[Abstract]:Objective to analyze and compare the clinical efficacy of nephron sparing Surgeryand radical nephrectomy in the treatment of localized renal cell carcinoma. Methods the data of 180 patients treated with NSS or RN from January 2008 to December 2013 were retrospectively analyzed. One hundred and thirty-seven patients with renal cell carcinoma were followed up for 3.-.72 months. The median follow-up time was 29 months. The age, sex, preoperative clinical manifestation, tumor size and postoperative TNM stage of 137 patients with renal carcinoma were compared and analyzed. The overall survival rate, tumor-specific survival rate and disease-free survival rate of the two groups were analyzed by Kaplan-Meier method. Results the operation was successfully completed in both groups. For 51 patients with renal cell carcinoma 鈮，

本文編號(hào)：1654554