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肾细胞癌的外科治疗:开放手术与腹腔镜手术的比较。

Surgical Management of Renal Cell Carcinoma: Comparisons of open and laparoscopic approaches.

机构信息

Department of Surgery, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2024 Aug;24(3):383-387. doi: 10.18295/squmj.6.2024.033. Epub 2024 Aug 29.

DOI:10.18295/squmj.6.2024.033
PMID:39234317
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11370946/
Abstract

OBJECTIVES

Renal cell carcinoma (RCC) is a leading urological malignancy with an age-standardised incidence rate of 2.5 per 100,000 per year in Oman. Experts are inclined towards the early detection and use of minimally invasive technology for the treatment of RCC. This study aimed report the shifting trend in the clinical presentation and management of RCC in Oman, comparing the outcomes of laparoscopic and open nephrectomy.

METHODS

This retrospective study included adult RCC patients from Sultan Qaboos University Hospital, Muscat, Oman, diagnosed from 2011-2022. Patient biodata, mode of presentation, diagnostic modality, final histopathology and details of treatment received including the perioperative outcomes were analysed.

RESULTS

A total of 56 patients that underwent surgical treatment for RCC, 34 underwent laparoscopic nephrectomy (LN) and 22 underwent open nephrectomy (ON). The mean ages in the LN and ON groups were 53.82 ± 13.44 years and 56.22 ± 15.00 years ( = 0.53), respectively. There were 47 patients of Omani descent and 9 patients were expatiates. The patients' mean tumour size was 6.25 ± 3.16 cm and 9.23 ± 5.20 cm for the LN and ON groups, respectively; 55.35% of the RCC cases were incidentally diagnosed. A trend towards LN was observed.

CONCLUSION

This study found a trend towards early diagnosis of RCC in Oman, with the majority of cancers being discovered incidentally in the studied period. LN is more commonly used in the surgical management of RCC with acceptable morbidity. These trends remain aligned with those found in the global literature on RCC.

摘要

目的

肾细胞癌(RCC)是一种主要的泌尿系统恶性肿瘤,在阿曼的年龄标准化发病率为每年每 10 万人 2.5 例。专家倾向于早期发现并使用微创技术治疗 RCC。本研究旨在报告阿曼 RCC 的临床表现和治疗方式的变化趋势,比较腹腔镜和开放性肾切除术的结果。

方法

本回顾性研究纳入了 2011 年至 2022 年在阿曼马斯喀特苏丹卡布斯大学医院诊断为 RCC 的成年患者。分析了患者的生物数据、表现方式、诊断方式、最终组织病理学以及接受的治疗细节,包括围手术期结果。

结果

共有 56 例患者接受了 RCC 的手术治疗,其中 34 例行腹腔镜肾切除术(LN),22 例行开放性肾切除术(ON)。LN 和 ON 组的平均年龄分别为 53.82 ± 13.44 岁和 56.22 ± 15.00 岁(= 0.53)。患者中 47 例为阿曼人,9 例为外国人。LN 和 ON 组患者的平均肿瘤大小分别为 6.25 ± 3.16cm 和 9.23 ± 5.20cm;55.35%的 RCC 病例为偶发性诊断。观察到 LN 的应用呈上升趋势。

结论

本研究发现阿曼 RCC 的早期诊断呈上升趋势,在研究期间大多数癌症是偶然发现的。LN 在 RCC 的手术治疗中更为常用,且发病率可接受。这些趋势与全球 RCC 文献中的趋势一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/785a/11370946/b47bdf277b38/squmj2408-383-387f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/785a/11370946/b47bdf277b38/squmj2408-383-387f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/785a/11370946/b47bdf277b38/squmj2408-383-387f1.jpg

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Renal cell carcinoma: an overview of the epidemiology, diagnosis, and treatment.肾细胞癌:流行病学、诊断和治疗概述。
G Ital Nefrol. 2022 Jun 20;39(3):2022-vol3.
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Trends in the surgical management of renal cell carcinoma in a contemporary tertiary care setting.当代三级医疗环境中肾细胞癌手术治疗的趋势
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Meta-analysis of the prevalence of renal cancer detected by abdominal ultrasonography.Meta 分析腹部超声检查发现的肾癌患病率。
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Cent European J Urol. 2016;69(4):341-346. doi: 10.5173/ceju.2016.845. Epub 2016 Sep 22.
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Systematic Review and Meta-Analysis of Comparative Studies Reporting Perioperative Outcomes of Robot-Assisted Partial Nephrectomy Versus Open Partial Nephrectomy.机器人辅助部分肾切除术与开放性部分肾切除术围手术期结果比较研究的系统评价和荟萃分析
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Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis.肾脏肿块和局限性肾癌的治疗:系统评价和荟萃分析。
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Nephron-sparing surgery across a nation - outcomes from the British Association of Urological Surgeons 2012 national partial nephrectomy audit.全国范围内的保留肾单位手术——英国泌尿外科医师协会2012年全国性部分肾切除术审计结果
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EAU guidelines on renal cell carcinoma: 2014 update.EAU 指南:肾细胞癌. 2014 年更新版.
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