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保留腎單位手術(shù)治療腎竇血管平滑肌脂肪瘤的經(jīng)驗總結(jié)

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Surgical experience of nephron-sparing surgery for the treatment of renal sinus angiomyolipoma

XU Chuxiao，PAN Dameng，LIU Lei，WANG Guoliang，MA Lulin，ZHANG Shudong

（Department of Urology，Peking University Third Hospital，Beijing 100191，China）

ABSTRACT：Objective To investigate the efficacy of nephron-sparing surgery （NSS） for the treatment of renal sinus angiomyolipoma and summarize the surgical experience.Methods The clinical data and follow-up results of 10 cases of renal sinus angiomyolipoma treated during Sep.2014 and Feb.2022 in our hospital were retrospectively analyzed.Results The patients included 1 male and 9 female.The mean tumor diameter was （5.7±2.8） cm.The RENAL score was 8 in 1 case，9 in 3 cases，10 in 4 cases，and 11 in 2 cases.Retroperitoneal laparoscopic partial nephrectomy was conducted in 3 cases，robot-assisted laparoscopic partial nephrectomy in 3 cases，and open partial nephrectomy by transabdominal approach in 4 cases.All operations were successful.The median operation time was 225 （97-340） minutes and the median warm ischemic time was 30.5 （5-43） minutes.Two patients underwent renal vein clamping simultaneously，with clamping time of 18 and 29 minutes，respectively.The median estimated blood loss was 200（10-600） mL，and no patients received blood transfusion.The difference between postoperative and preoperative hemoglobin concentration was statistically significant [113 （94-130） g/L vs.136 （95-150） g/L，P=0.041].The difference between the postoperative and preoperative serum creatinine level was not statistically significant [58（35-89） μmol/L vs. 62（39-77） μmol/L，P=0.722].One case suffered lymphorrhagia （Clavien-Dindo grade Ⅰ） and recovered with conservative treatment; 1 case experienced local recurrence after a follow-up of 99 months; 9 patients recovered uneventfully without any postoperative complications.Conclusion NSS is an effective treatment strategy for renal sinus angiomyolipoma.Complete resection plays a key role.Due to possible recurrence，long-term follow-up is recommended.

KEY WORDS：renal tumor; angiomyolipoma; renal sinus; nephron-sparing surgery

摘要：目的 分析保留腎單位手術(shù)（NSS）治療腎竇血管平滑肌脂肪瘤（AML）的療效，并總結(jié)手術(shù)經(jīng)驗。（剩余9532字）

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