外控式肾蒂阻断带在腹腔镜保留肾单位手术中的应用  

Application of external controlled renal pedicle occlusive belt in laparoscopic nephron-sparing surgery

作　　者：付德来[1] 李钊伦[1] 张鹏[1] 陈宏伟 万紫妍 王子明[1] 种铁[1] 李和程[1] 

机构地区：[1]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《现代泌尿外科杂志》2017年第12期896-898,906,共4页Journal of Modern Urology

基　　金：国家自然科学基金(No.81072106)

摘　　要：目的探讨外控式肾蒂阻断带在腹腔镜保留肾单位手术中的应用价值。方法回顾性分析我院2015年6月至2017年5月因肾肿瘤行保留肾单位手术资料,按照肾蒂阻断方式的不同分为常规Bulldog肾蒂阻断组(对照组)和外控式肾蒂阻断带组(试验组),分析两组手术时间、出血量、肿瘤RENAL评分、热缺血时间差异。结果共收集入组患者119例(对照组87例,试验组32例),两组患者肿瘤RENAL评分无差异,对照组出血量(133±100)mL,试验组出血量(207±94)mL,差异具有统计学意义;试验组手术时间(156.66±66.30)min,对照组(136.76±57.85)min,差异无统计学意义;对照组热缺血时间(19.69±6.46)min,试验组热缺血时间(12.81±4.48)min,试验组较对照组显著缩短。结论外控式肾蒂阻断带在腹腔镜保留肾单位手术中安全、可靠,联合早期开放肾蒂,可显著缩短热缺血时间,值得推广。Objective To explore the applicative value of exterior-controlled occlusive belt （ECOB） in laparoscopic nephron-sparing surgery （LNSS）. Methods Data of LNSS operation performed in our hospital during Jun. 2015 and May 2017 were evaluated retrospectively. According to the approach of renal pedicle occlusion, patients were assigned into Bulldog group （control group） and ECOB group （study group）. Parameters related to surgical outcomes, such as blood loss, operation time, RENAL score, and warm ischemia time （WIT） were analyzed. Results A total of 119 patients were enrolled in the study （87 in the control and 32 in the study group）. There were no statistical differences in the RENAL score, and operation time [ （156.66 ± 66.30） min vs. （ 136.76 ± 57.85） mini between the study and control groups. A statistical increase of blood loss [-（207±94）mL vs. （133±100）mL] and a decrease of WIT [（12.81±4.48）min vs. （19.69±6.46）mini were noted in the study group. Conclusion ECOB is a safe and reliable way for renal pedicle blockage in LNSS, which can markedly reduce WIT. Application of ECOB in LNSS is worthy of clinical promoting.

关 键 词：肾癌 腹腔镜保留肾单位手术 热缺血时间 肾蒂阻断带 

分 类 号：R737.11[医药卫生—肿瘤]