Israel Gary M, Hecht Elizabeth, Bosniak Morton A
Department of Radiology, Yale University School of Medicine, PO Box 208042, 333 Cedar St, New Haven, CT 06520-8042, USA.
Radiographics. 2006 Sep-Oct;26(5):1419-29. doi: 10.1148/rg.265065701.
The standard treatment for renal cell carcinoma for many years was radical nephrectomy, but in the past decade there has been a trend toward elective nephron-sparing surgery. Initially, partial nephrectomy was performed with an open surgical approach; more recently and with increasing frequency, a laparoscopic approach has been used in selected cases. Nephron-sparing surgery with either approach is more complex than is traditional radical nephrectomy and more frequently results in complications. The possible complications of partial nephrectomy include vascular, collecting system, and technical complications as well as recurrent tumor and infection. For prompt diagnosis and appropriate management of these complications, radiologists must be familiar with normal and abnormal features in the postoperative appearance of the kidney at computed tomography and magnetic resonance imaging.
多年来,肾细胞癌的标准治疗方法是根治性肾切除术,但在过去十年中,出现了一种倾向于选择性保留肾单位手术的趋势。最初,部分肾切除术采用开放手术方式进行;最近,在某些特定病例中,腹腔镜手术方式的使用频率越来越高。无论采用哪种方式,保留肾单位手术都比传统的根治性肾切除术更为复杂,且更易引发并发症。部分肾切除术可能的并发症包括血管、集合系统、技术方面的并发症以及肿瘤复发和感染。为了对这些并发症进行及时诊断和恰当处理,放射科医生必须熟悉肾脏在计算机断层扫描和磁共振成像术后表现中的正常及异常特征。