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肾切除术治疗腹膜后肉瘤对术后肾功能的影响。

Effect of nephrectomy for retroperitoneal sarcoma on post-operative renal function.

作者信息

Kim Daniel B, Gray Richard, Li Zhuo, Wasif Nabil, Bagaria Sanjay P

机构信息

Department of Surgery, Mayo Clinic, Jacksonville, Florida.

Department of Surgery, Mayo Clinic, Scottsdale, Arizona.

出版信息

J Surg Oncol. 2018 Mar;117(3):425-429. doi: 10.1002/jso.24875. Epub 2017 Oct 16.

Abstract

BACKGROUND AND OBJECTIVES

Surgical resection of retroperitoneal sarcomas (RPS) often involves removal of the ipsilateral kidney. We evaluated the long-term post-operative renal function in patients who underwent a nephrectomy as part of their en-bloc resection of RPS.

METHODS

Retrospective review of an institutional database identified RPS patients who underwent nephrectomy for curative intent from 1990 to 2014. The primary outcome measured was chronic kidney disease (CKD) calculated by the glomerular filtration rate (GFR).

RESULTS

Of the 47 patients in our study, 19 (40%), 18 (38%), and 10 (21%) patients had a preoperative CKD stage 1, 2, and 3, respectively. The GFR decreased by an average of 33.4 mL/min/1.73 m with 66% of patients demonstrating mild progression of their renal impairment. Only three (6%) patients progressed to CKD stage 4 or 5, one of which required life-long dialysis.

CONCLUSION

Nephrectomy as part of an en-bloc resection is associated with a decrease in GFR that is not clinically significant. Fear of kidney failure should not prevent a surgeon from performing a nephrectomy in the treatment of RPS.

摘要

背景与目的

腹膜后肉瘤(RPS)的手术切除通常需要切除同侧肾脏。我们评估了在RPS整块切除术中接受肾切除术患者的术后长期肾功能。

方法

对机构数据库进行回顾性分析,确定1990年至2014年期间因治愈目的接受肾切除术的RPS患者。主要观察指标是通过肾小球滤过率(GFR)计算的慢性肾脏病(CKD)。

结果

在我们研究的47例患者中,术前CKD 1期、2期和3期的患者分别有19例(40%)、18例(38%)和10例(21%)。GFR平均下降33.4 mL/min/1.73m²,66%的患者肾功能轻度进展。只有3例(6%)患者进展至CKD 4期或5期,其中1例需要终身透析。

结论

作为整块切除术一部分的肾切除术与GFR下降有关,但在临床上无显著意义。对肾衰竭的担忧不应阻止外科医生在RPS治疗中进行肾切除术。

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