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[肾脏与其他器官的一期联合手术]

[One-stage combined operations on kidney and other organs].

作者信息

Fedorov V D, Tsvirkun V V, Neshitov S P, Tarasiuk T I

出版信息

Khirurgiia (Mosk). 2001(1):22-6.

Abstract

Patients with combined diseases of the kidney, organs of abdominal cavity and retroperitoneal space require original decisions in the choice of surgical approach and sequence of interventions on different organs. The experience of one-stage combined nephrectomies and kidney resections in 36 patients with lung, stomach, intestine, liver and other organs' diseases are presented. 11 patients had primary renal carcinoma, the kidneys were affected by other malignant tumors in 15 patients. Primary benign processes in the kidneys were found in 3 patients and also in 7 patients these processes were the consequence of earlier performed operations. Interventions on 3-6 organs were necessary in 11 cases. It makes sense to begin one-stage combined transperitoneal interventions with "clean" stages--without section of gastrointestinal tract's lumen. 1 patient died because of peritonitis due to insufficiency of sutures of colon anastomosis. The follow-up ranged from 6 months to 12 years. The recurrences and metastases were found in 9 operated patients within 7 to 20 months, and there were no symptoms of diseases in 24 patients. It is concluded that extended radical one-stage operations on the organs of abdominal cavity and retroperitoneal space combined with operations on the kidney are endurable and effective if the surgical technique is thorough.

摘要

患有肾脏、腹腔和腹膜后间隙联合疾病的患者在选择手术入路和对不同器官进行干预的顺序时需要有独到的决策。本文介绍了36例患有肺部、胃部、肠道、肝脏和其他器官疾病的患者进行一期联合肾切除术和肾脏切除术的经验。11例患者患有原发性肾癌,15例患者的肾脏受到其他恶性肿瘤的影响。3例患者的肾脏存在原发性良性病变,7例患者的这些病变是早期手术的结果。11例患者需要对3至6个器官进行干预。从“清洁”阶段开始进行一期联合经腹手术是有意义的,即不切开胃肠道管腔。1例患者因结肠吻合口缝合不充分导致腹膜炎死亡。随访时间为6个月至12年。9例接受手术的患者在7至20个月内出现复发和转移,24例患者无疾病症状。结论是,如果手术技术完善,对腹腔和腹膜后间隙器官进行扩大根治性一期手术并联合肾脏手术是可行且有效的。

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