Objective To investigate the clinical application effects of open lumbar anatomical radical nephrectomy in T1 Renal cell carcinoma (RCC).Methods We dissociated anatomically anterior and post diastema of peri-renal fascia and isolated the vessel of kidney,and successively blocked renal arteries and veins,then removed kidney and tumor.The clinical information of 39 patients was analyzed to see the results of the treatment.Results All cases of surgeries were successful.23 cases of tumor diameter were less than 4 cm,and operation time was 60～90 minutes.The mean operation time was 65 minutes,and the bleeding quantity was 20 ～50 ml.Also,there was 16 cases of tumor diameter was between 4cm to 7 cm,and operation time was 80～120 minutes.The mean operation time was 95 minutes,and the bleeding quantity was 30 ～100 ml; however,there were not injuries in pleura and postcava.The time of hospital stay was 7 ～10 days,and the mean time was 9 days.All cases were followed by 3～36 months.There were no patients needing metastasis.Conclusion Open lumbar anatomical radical nephrectomy is associate with higher safety,lower blood loss,higher usefulness,lower recurrence rate.It is a very useful method for basic level hospital to treat T1 RCC.%目的 探讨腰部解剖性入路在T1期肾癌根治术中的应用.方法 39例T1期肾癌患者解剖性分离肾周筋膜后间隙和肾前间隙,先行阻断肾动静脉,在肾周筋膜外将肾脏及肿瘤完整切除,随访观察疗效.结果 39例手术均顺利完成.23例肿瘤直径＜ 4cm,手术时间60 ～ 90 min,平均65 min,术中出血量20 ～ 50ml;16例肿瘤直径4～7cm,手术时间80 ～ 120 min,平均95 min,术中出血量30～100 ml,无胸膜及下腔静脉损伤.术后住院时间7～10d,平均9天,随访时间3～ 36个月,肿瘤无复发转移.结论 腰部解剖性入路行T1期肾癌根治术安全,出血少,实用性强,复发率低,是适用于基层医院的一种有效的开放术式.
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