后腹腔镜下肾癌根治术的疗效分析及术后不同剂量IL-2免疫治疗中的疗效评价

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (8): 926-930.

后腹腔镜下肾癌根治术的疗效分析及术后不同剂量IL-2免疫治疗中的疗效评价

潘彩明, 黄后宝, 邱成

皖南医学院弋矶山医院泌尿外科, 芜湖 241001,安徽

收稿日期:2014-05-18 修回日期:2014-08-12 出版日期:2014-08-26 发布日期:2014-08-26
作者简介:潘彩明,男,主治医师,在职研究生,从事泌尿外科疾病的诊治,擅长泌尿外科肿瘤的诊治。 Tel: 13905537712 E-mail: pancaiming@yeah.net

Evaluation of therapeutic efficiency of laparoscopic radical nephrectomy and postoperative immunotherapy with different doses of IL-2

PAN Cai-ming, HUANG Hou-bao, QIU Cheng

Department of Urology, Yijishan Hospital of Wannan Medical College, Wuhu 241001,Anhui, China

Received:2014-05-18 Revised:2014-08-12 Online:2014-08-26 Published:2014-08-26

摘要/Abstract

摘要： 目的探讨后腹腔镜下肾癌根治术的临床疗效与体会及术后不同剂量IL-2免疫治疗的效果评价。方法回顾分析38例肾癌患者,均采用后腹腔镜肾癌根治术,其中,透明细胞癌33例,乳头状肾细胞癌2例,颗粒色细胞癌3例。观察手术时间、术中出血量、术后胃肠道功能恢复时间、拔除引流管时间、术后平均住院时间及并发症。术后分组给予IL-2 18 mL U/m²及 1 mL U/m²进行生物免疫治疗,并进行疗效评价及进行不良反应的比较。结果 38例患者,均获成功。手术时间60~180 min,平均(80±20) min。术中出血30~100 mL,平均(50±10) mL。术后1~3 d 胃肠道功能恢复,平均(1.0±0.3) d。术后2~5 d 拔除引流管,平均(3.0±0.2) d。术后平均住院时间5~8 d,平均(6.0±0.5) d,术后无继发出血及切口感染。术后经病理证实为肾细胞癌。术后随访3~48月,平均(24±4)月,两组不同剂量IL-2免疫治疗患者在局部复发、远处转移、死亡及完全缓解等疗效分析上无明显差异,而在治疗期间不良反应上存在统计学差异。结论后腹腔镜下肾癌根治术安全、有效且并发症少,术后结合生物免疫制剂治疗,可有效延缓肾癌复发及远处转移,且小剂量的IL-2也能达到大剂量的治疗效果。

关键词: 肾癌, 腹腔镜手术, 腹膜后途径, 根治性肾切除术, 白介素-2

Abstract: AIM: To evaluate the therapeutic efficiency of laparoscopic radical nephrectomy and postoperative immunotherapy with different doses of IL-2. METHODS: A total of 38 patients underwent laparoscopic radical nephrectomy were enrolled. There were 33 patients with clear cell carcinoma, 2 patients with papillary renal cell carcinoma and 3 patients with granular cell carcinoma. Operative time, intraoperative bleeding, recovery time of gastrointestinal function, remove time of drainage tube, average hospital stay after operation and postoperative complications were investigated. All patients were divided into two groups according to postoperative immunotherapy with different doses of IL-2: group 1 (18 mL U/m²) and group 2 (1 mL U/m²). The therapeutic efficiency and the adverse reactions between groups were also been compared.RESULTS: A total of 38 patients underwent laparoscopic radical nephrectomy were enrolled. There were 33 patients with clear cell carcinoma, 2 patients with papillary renal cell carcinoma and 3 patients with granular cell carcinoma. Operative time, intraoperative bleeding, recovery time of gastrointestinal function, remove time of drainage tube, average hospital stay after operation and postoperative complications were investigated. All patients were divided into two groups according to postoperative immunotherapy with different doses of IL-2: group 1 (18 mL U/m²) and group 2 (1 mL U/m²). The therapeutic efficiency and the adverse reactions between groups were also been compared.CONCLUSION: Laparoscopic radical nephrectomy is safe, effective and fewer complications. Postoperative IL-2 immunotherapy can effectively delay recurrence and distant metastasis of renal cell carcinoma. The therapeutic efficiency of postoperative immunotherapy with low-dose trial of IL-2 is similar to high-dose trial of IL-2.

Key words: renal cell carcinoma, laparoscopic surgery, retroperitoneal approach, radical nephrectomy, Interleukin-2(IL-2)

中图分类号:

潘彩明, 黄后宝, 邱成. 后腹腔镜下肾癌根治术的疗效分析及术后不同剂量IL-2免疫治疗中的疗效评价[J]. 中国临床药理学与治疗学, 2014, 19(8): 926-930.

PAN Cai-ming, HUANG Hou-bao, QIU Cheng. Evaluation of therapeutic efficiency of laparoscopic radical nephrectomy and postoperative immunotherapy with different doses of IL-2[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(8): 926-930.

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