影响经腹腔肾盂后逆行游离控制肾蒂肾癌根治术手术路径因素的MDCT分析  

The influential factors of operational pathway for radical nephrectomy by post-pyelic retrograde free control of renal pedicle analyzed by MDCT

作　　者：关文华[1] 李志军[2] 韩焱[1] 文红[1] 张璇[1] 陈殿森[1] 

机构地区：[1]河南科技大学第一附属医院影像中心,河南省洛阳市471003 [2]河南科技大学第一附属医院泌尿外科,河南省洛阳市471003

出　　处：《实用医学杂志》2012年第21期3596-3598,共3页The Journal of Practical Medicine

基　　金：河南省卫生科技创新型人才工程(2010~2020年)专项经费资助项目(编号:04205);洛阳市科技局科技攻关项目(编号:0904047B)

摘　　要：目的:采用MDCT扫描探讨影响经腹腔肾盂后逆行游离控制肾蒂肾癌根治术手术路径的相关因素。方法:对拟行肾盂后逆行游离控制肾蒂肾癌根治术的68例患者行CT增强扫描,观察并记录影响肾盂后间隙的相关因素。结果:(1)不适合肾盂后间隙入路的因素(43.3%),主要是肿瘤侵及周围结构和因肿瘤原因而导致的肾蒂结构移位、扭曲;(2)增加操作难度的因素(56.7%),主要是肾动脉异常、肾静脉或下腔静脉内癌栓形成、肾盂-输尿管积水、腹膜后淋巴结转移等。Objective To approach influential tactors of operational pathway for radical nephrectomy by post- pyelic retrograde free control of renal pedicle by MDCT. Methods MDCT enhancement scanning was performed in 68 patients before radical nephrectomy. Post-pyelic interspaces were observed through reconstructed images and the influential factors were recorded. Results （ 1 ） The inadaptable factors （43.3%） of post-pyelic interspaces approach included tumors invaded surrounding structures or renal pedicle shifting and retortion extruded by tumors. （2） The influencing operational factors （56.7%） included abnormal renal artery, cancer embolus of renal veins or inferior vena cava, hydronephrosis or hydroureter, and retroperitoneal lymph node metastasis. Conclusion MDCT can provide evaluation of post-pyelic interspaces for radical nephrectomy by post-pyelic retrograde free control.

关 键 词：肾肿瘤 肾癌根治术 肾盂后间隙 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤]