Kostiukov S I, Medvedev V L, Kogan M I
Urologiia. 2008 May-Jun(3):21-4.
A total of 322 patients with cystic lesions were examined with contrast-enhanced computed tomography from 1998 to 2005. Of them, 104 patients have undergone transperitoneal or retroperitonial laparoscopic surgery. 21 patients of the latter were diagnosed to have cystic lesions Bosniak III and 4 patients--Bosniak IV. It is difficult to differentiate cysts Bocniak II and III even pathomorphologically. Cystic carcinoma was detected histologically in 8 Bosniak III cases. Partial nephrectomy was made in 7 cases and radical nephrectomy in 1 case. Renal cell carcinoma was detected in 3 of 4 Bosniak IV cases, oncocytoma--in 1 case. Thus, renal cancer was confirmed in 8 cases (38%) of Bosniak III and 3 cases of Bosniak IV. During the mean follow-up of 40 months no events of local recurrence, progression or tumor growth in places of trocar installation were detected. Cases of cancer specific mortality were not observed. Cystic lesion Bosniak III and IV are subject for surgical treatment. The method of choice is laparoscopic transperitoneal partial nephrectomy and radical nephrectomy.
1998年至2005年期间，共有322例囊性病变患者接受了增强CT检查。其中，104例患者接受了经腹或腹膜后腹腔镜手术。后者中有21例被诊断为博斯尼亚克III级囊性病变，4例为博斯尼亚克IV级。即使在病理形态学上，也很难区分博斯尼亚克II级和III级囊肿。在8例博斯尼亚克III级病例中，组织学检查发现了囊性癌。7例行部分肾切除术，1例行根治性肾切除术。4例博斯尼亚克IV级病例中有3例检测到肾细胞癌，1例为嗜酸细胞瘤。因此，8例（38%）博斯尼亚克III级和3例博斯尼亚克IV级病例确诊为肾癌。在平均40个月的随访期间，未发现局部复发、进展或套管针置入部位肿瘤生长的情况。未观察到癌症特异性死亡病例。博斯尼亚克III级和IV级囊性病变需接受手术治疗。首选方法是腹腔镜经腹部分肾切除术和根治性肾切除术。
