保留肾单位手术与肾癌根治术治疗局限性肾癌疗效对比

摘要

目的:探讨保留肾单位手术与肾癌根治术治疗局限性肾癌的疗效差异.方法:2000年1月至2006年1月诊治的80例局限性肾癌患者分为开放保留肾单位手术组(NSS组)和开放肾癌根治术组(ORN组),比较两组患者在手术疗效和手术前后生存质量的差异.结果:NSS组手术时间、肾蒂阻断时间、术中失血量、住院时间和术后引流时间均显著高于ORN组(P<0.05);两组患者手术前血清肌酐无明显差异(P>0.05),NSS组术后1个月、1年、2年和3年的血清肌酐均显著低于ORN组(P<0.05);两组患者术后并发症无明显差异(P>0.05);术后随访3年提示两组患者在复发、远处转移、复发+转移、肿瘤致死率及3年无瘤生存率方面无明显差异(P>0.05);两组患者手术前的生存质量无明显差异(P>0.05),NSS组患者术后生存质量改善程度显著高于ORN组(P<0.05).结论:保留肾单位手术与肾癌根治术治疗局限性肾癌术术后并发症及肿瘤复发无明显差异,但保留肾单位手术能更好地保留肾功能,提高患者生存质量.%Objective:To compare nephron sparing surgery and radical nephrectomy' s curative effects on localized renal carcinoma.Methods:80 cases with localized renal carcinoma between Jan 2000 and Jan 2006 were divided into nephron sparing surgery group (NSS) and open radical nephrectomy group (ORN) according their surgical methods. The curative effects and quality of life were compared.Results:The operation time, renal pedicle blocking, loss of blood, inpatient time and drainage time in NSS group were significantly higher than ORN group (P<0.05), while it was lower in creatinine after surgery (PO.05). The recurrence, metastasis, lethality rate and disease free survival in NSS group showed none differences from ORN group (P>0.05), while it was higher in postoperative quality of life (P<0.05).Conclusion:Nephron sparing surgery and open radical nephrectomy show no differences in complications and recurrences, but nephron sparing surgery could significantly protect residual renal function and promote postoperative quality of life.