Department of Urologic Surgery, the E. Wolfson Medical Center, Holon, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
BJU Int. 2011 Oct;108(8):1330-4. doi: 10.1111/j.1464-410X.2010.09995.x. Epub 2010 Dec 24.
• To describe our experience with laparoscopic partial nephrectomy (LPN) for multiple kidney tumours and compare the outcomes with LPN performed for single masses.
• Retrospective analysis of medical records of patients undergoing LPN at our institution between 2005 and 2009 was performed. • The cohort was divided in two groups based on tumour focality: group 1, LPN for a single tumour (n= 99) and group 2, LPN for multiple ipsilateral tumours (n= 12). • The groups were compared with regards to demographic and peri-operative variables.
• Demographic variables were not different between the groups. Median dominant tumour size was 3.1 cm (interquartile range [IQR] 2.4-4.0) and 4.0 cm (2.3-5.9) in groups 1 and 2, respectively. • Median secondary tumour size in group 2 was 1.0 cm (1.0-1.8). • Operative times were longer in group 2 compared with group 1 (220 vs 160 min, P= 0.009). • Warm ischaemia times (WIT) (23 vs 22 min) and estimated blood loss (EBL) (100 vs 85 mL) were similar.
• LPN is a viable option for the treatment of multiple ipsilateral renal tumours. • Peri-operative outcomes are similar to standard LPN with the exception of longer operative time. • In experienced hands, the advantages of minimally invasive surgery may be extended to select patients with ipsilateral multifocal renal tumours.
描述我们在腹腔镜部分肾切除术（LPN）治疗多个肾肿瘤方面的经验，并将其与单病灶 LPN 的结果进行比较。
对 2005 年至 2009 年在我院接受 LPN 的患者的病历进行回顾性分析。根据肿瘤灶的位置，将队列分为两组：组 1，LPN 治疗单个肿瘤（n=99）和组 2，LPN 治疗多个同侧肿瘤（n=12）。比较两组患者的人口统计学和围手术期变量。
两组患者的人口统计学变量无差异。中位优势肿瘤大小分别为 3.1cm（四分位距[IQR] 2.4-4.0）和 4.0cm（2.3-5.9），组 2 中位次要肿瘤大小为 1.0cm（1.0-1.8）。与组 1 相比，组 2 的手术时间更长（220 分钟 vs 160 分钟，P=0.009）。热缺血时间（WIT）（23 分钟 vs 22 分钟）和估计失血量（EBL）（100 毫升 vs 85 毫升）相似。
LPN 是治疗多个同侧肾肿瘤的可行选择。与标准 LPN 相比，围手术期结果相似，除了手术时间更长。在有经验的医生手中，微创外科的优势可能扩展到选择同侧多灶性肾肿瘤的患者。
