摘要
目的探讨一种新的肾血管阻断技术在腹腔镜肾部分切除术中的应用及临床价值。方法2011年3—6月，对10例肾脏小肿瘤患者应用高选择性肾动脉分支阻断技术，行腹腔镜肾部分切除术。男6例，女4例，平均年龄（47±13）岁，平均肿瘤直径约（2．8±0．9）em。观察手术时间、术中出血量、高选择性肾动脉分支阻断时间、引流管留置时间、术后住院天数、并发症及手术效果。结果手术均顺利完成，平均手术时间（101±23）min，术中中位出血量112ml，术中平均高选择性肾动脉分支阻断时间（28±6）min，无输血、中转开放手术病例。术中及术后无并发症，肾周引流管平均留置时间为（5．0±1．3）d，平均术后住院时间（8．0±0．8）d，术后随访时间（4．0±1．1）个月。病理回报4例肾血管平滑肌脂肪瘤；5例肾透明细胞癌，切缘阴性；1例肾乳头状细胞癌，切缘阴性。结论高选择性肾动脉分支阻断技术是一种新的肾血管阻断技术，在肾部分切除术中安全有效，但需要长期随访及大宗病例研究。
Objective To explore the feasibility and efficiency of new clamping technique of renal arterial branches during laparoscopic partial nephrectomy. Methods Between March and June 2011, 10 patients （6 males, 4 females） with small renal tumor underwent laparoscopic partial nephrectomy with highly selective clamping of renal arterial branches. The mean age was （47 ± 13 ） years and the mean tumor size （2. 8 ± 0. 9 ） cm. Operative duration, estimated blood loss, time for highly selective clamping of renal arterial branches, postoperative hospital stay, indwelling duration of drainage tube and complications were recorded. Results The operations were successfully performed in all patients. The mean operative duration was （101 ±23） min, the mean estimated blood loss 112 ml and the mean time for the clamping of renal arterial branches （28± 6） min. There was neither blood transfusion nor conversion into open surgery. The mean indwelling duration of drainage tube was （ 5.0± 1.3 ） days and the mean postoperative hospital stay （ 8.0± 0. 8 ） days. The recovery of all patients was uneventful. Conclusion Highly selective clamping of renal arterial branches is a new method of protecting renal function during laparoscopic partial nephrectomy. Further studies and a longer follow-up are warranted.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第18期1275-1277,共3页
National Medical Journal of China
关键词
腹腔镜
肾切除术
热缺血
肾肿瘤
Laparoscopes
Nephrectomy
Warm ischemia
Kidney neoplasms
