中文摘要：

目的评估保留肾单位手术（NSS）在肾细胞癌治疗中的应用情况。方法回顾性总结了221例接受NSS治疗的肾细胞癌患者的临床资料,其中203例为开放手术,18例为腹腔镜手术;115例术中行肾动脉阻断降温,96例未阻断;136例行肿瘤周边肾组织活检;186例术后注射干扰素及白细胞介素进行免疫治疗。术后平均随访28个月（3～56个月）。结果手术切除肾组织范围平均距瘤体0.4cm（0.2～1.0cm）,术中平均出血180ml（50～1000ml）。术后病理检查示透明细胞癌195例,嫌色细胞癌12例,乳头状肾细胞癌7例,囊性肾细胞癌6例,透明细胞癌伴肉瘤样变1例;136例肿瘤周边活检组织均为阴性。术后漏尿6例,出血及血尿5例,下肢血栓形成2例。随访期内无死亡病例,肿瘤复发4例（1.8%）,远处转移3例（1.4%）。结论在适应证选择合适情况下,NSS可安全有效治疗肾细胞癌。

英文摘要：

Objective To evaluate the application of nephron-sparing surgery （NSS） in the treatment of renal cell carcinoma （RCC）. Methods The clinical data of 221 RCC patients who received nephron-sparing surgery were retrospectively reviewed. Open surgery was performed for 203 cases and laparoscopic surgery for 18 cases. The renal arteries were blocked and ice fragments were used for 115 patients, Biopsy was performed on renal tissue adjacent the tumor for 136 patients. After operation 156 patients were treated with interferon and interleukin Ⅱ. Among these 221 patients, 132 patients （59.7%） were followed for 3-56 months （mean： 28 months）. Results The mean distance from the edge of normal tissue to the tumor was 0.4 cm （0.2-1.0 cm）. The mean volume of blood loss was 180 ml （50-1 000 ml）. Pathological examination showed clear cell carcinoma （ n = 195 ） , chromophobe renal carcinoma （ n = 12 ） , papillary renal carcinoma （ n = 7 ）, cystic renal carcinoma （ n = 6 ）, and sarcomatoid clear cell carcinoma （ n = 1 ）. Biopsies in 136 patients showed negative results. Post-operative complications included leakage of urine （ n = 1 ） , hemorrhage or hema- turia （ n = 5 ）, and infarction of blood vessel of lower limbs （ n = 2 ）. During the follow-up, no patients died for this reason, although tumor recurrence （n = 4, 1.8% ） and metastasis （n = 3, 1.4% ） were noted. Conclusion NSS is a safe and effective method to treat carefully selected RCC patients