自约式半肾阻断带在肾部分切除术中的应用  

Application of self-retaining semi-nephron blocking belt in laparoscopic partial nephrectomy-Animal model studies

作　　者：杨波[1] 蔡建通 王辉清[1] 过菲[1] 肖亮[1] 孙颖浩[1] 

机构地区：[1]第二军医大学附属长海医院泌尿外科,上海200433 [2]福建省石狮市医院泌尿外科

出　　处：《中华实验外科杂志》2013年第12期2540-2541,共2页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨自约式半肾阻断带在肾部分切除术中的可行性、安全性及临床应用价值.方法 采用自约式半肾阻断带行腹腔镜下成年香猪肾部分切除术10例.将阻断带套至肾中极,收紧约束带,行肾下极部分切除术（切除大小约2 cm×2 cm）,术后解除阻断,记录术中出血量及安装和解除阻断带的时间.结果 手术均顺利进行.半肾阻断后见上半肾颜色红润,下半肾颜色苍白,手术创面未见明显出血,缝合后解除约束带,下半肾血供恢复.术中出血20～50 ml,安装阻断带时间4～11 min,解除阻断带时间为2～6 min.结论 通过自约式半肾阻断带法行肾部分切除术,可以减少热缺血的肾单位,从而减少肾功能的损伤.Objective To assess the feasibility,safety and the clinical significance of the use of self-retaining semi-nephron blocking belt in laparoscopic partial nephrectomy.Methods Self-retaining semi-nephron blocking belt was used in 10 cases of laparoscopic partial nephrectomy which was conducted on living pigs.The blocking belt was first located in the mid pole of kidney and frapped,and then the laparoscopic partial nephrectomy was conducted in lower kidney pole.The extent of resection was 2 cm × 2 cm.After the resection and suture,the self-retaining semi-nephron blocking belt was removed.The blood loss in the surgery and the time of installing and removing the blocking belt were recorded.Results All procedures were successfully completed without obvious complications.As the semi kidney was blocked,the ischemia change of lower kidney pole was obvious,while the upper was normal.There was no bleeding on the surface of the wound.The blood supply of the lower half of the kidney was restored by removing the belt.The average blood loss in the surgery was 20-50 ml,and the average time of installing and removing the belt was 4-11 min and 2-6 min separately.Conclusion By means of the self-retaining semi-nephron blocking belt we designed used in laparoscopic partial nephrectomy,the warm ischemia of cortical nephron was dramatically reduced,so that the damage of the renal function was decreased.

关 键 词：腹腔镜 肾部分切除术 热缺血 

分 类 号：R699.2[医药卫生—泌尿科学]