本文選題：后腹腔鏡　切入點(diǎn)：腎部分切除術(shù)　出處：《首都醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討中度及高度復(fù)雜性腎臟腫瘤行后腹腔鏡腎部分切除術(shù)的有效性和安全性。 方法：對(duì)2005年12月到2013年12月49例中度復(fù)雜性和7例高度復(fù)雜性腎臟腫瘤患者的臨床資料進(jìn)行回顧性分析，患者的平均年齡為53.20±14.51歲；平均BMI為24.57±3.50；腫瘤直徑平均為4.02±1.27cm；平均R.E.N.A.L評(píng)分為8.29±1.04；其中31例的腫瘤位于腹前側(cè)，而另外25例位于腹后側(cè)。本組56例患者均經(jīng)后腹腔鏡腎部分切除術(shù)完成腎臟腫瘤的治療。 結(jié)果：56例患者均取得了手術(shù)的成功，無(wú)術(shù)中中轉(zhuǎn)開(kāi)放病例，無(wú)術(shù)中輸血病例，并且罕見(jiàn)嚴(yán)重手術(shù)并發(fā)癥。手術(shù)用時(shí)142.68±47.51min；熱缺血時(shí)間28.54±6.40min；失血量175.71±160.06ml；住院時(shí)間16.68±4.74天；術(shù)后并發(fā)癥包括尿漏、發(fā)熱、肺部感染等，經(jīng)對(duì)癥治療均好轉(zhuǎn)。因術(shù)后血紅蛋白值快速下降而行輸血治療1例。嚴(yán)重并發(fā)癥發(fā)生在一例女性患者，該患者術(shù)后3天出現(xiàn)大量嚴(yán)重的血尿，，遂急診行開(kāi)放患腎切除術(shù)。 結(jié)論：中度及高度復(fù)雜性腎臟腫瘤經(jīng)后腹腔鏡腎部分切除術(shù)治療安全、有效，但其療效是不是優(yōu)于腹腔鏡根治性腎切除術(shù)還需長(zhǎng)時(shí)間的隨訪研究。
[Abstract]:Objective: to evaluate the efficacy and safety of retroperitoneal laparoscopic partial nephrectomy for moderate and high complex renal tumors. Methods: the clinical data of 49 patients with moderate complexity and 7 patients with high complexity renal tumor from December 2005 to December 2013 were retrospectively analyzed. The average age of the patients was 53.20 鹵14.51 years old. The mean BMI was 24.57 鹵3.50, the average diameter of tumor was 4.02 鹵1.27 cm, and the average R.E.N.A.L score was 8.29 鹵1.04.The tumors of 31 cases were located at the anterior side of the abdomen, while the other 25 cases were located at the posterior side of the abdomen. All the 56 cases were treated with retroperitoneal laparoscopic partial nephrectomy. Results the operation was successful in 56 cases. There were no cases of intraoperative conversion, no cases of intraoperative blood transfusion, and rare severe complications. The operative time was 142.68 鹵47.51 min, the warm ischemic time was 28.54 鹵6.40 min, the blood loss was 175.71 鹵160.06 ml, and the hospitalization time was 16.68 鹵4.74 days. Postoperative complications include urinary leakage, fever, pulmonary infection, etc. They were all improved by symptomatic treatment. Blood transfusion was performed in 1 case because of the rapid decrease in hemoglobin value after operation. Serious complications occurred in a female patient. The patient developed severe hematuria 3 days after operation and underwent open nephrectomy. Conclusion: retroperitoneal laparoscopic partial nephrectomy is safe and effective in the treatment of moderate and highly complex renal neoplasms, but whether the curative effect is better than that of laparoscopic radical nephrectomy still needs a long follow-up study.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R737.11

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