肾血管三维成像技术在机器人辅助腹腔镜肾部分切除术前肾动脉变异评估中的应用  

Application of three-dimensional angiography in the evaluation of renal artery variation before robotic-assisted laparoscopic partial nephrectomy

作　　者：赵健[1] 王忠新[1] 宋勇[1] 洪宝发[1] 张旭[1] 符伟军[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《现代泌尿外科杂志》2017年第12期921-924,共4页Journal of Modern Urology

摘　　要：目的探讨肾血管三维成像技术对机器人辅助腹腔镜肾部分切除术前肾动脉变异的评估价值以及研究肾动脉变异的意义。方法回顾解放军总医院泌尿外科2013年6月至2017年3月进行机器人辅助腹腔镜肾部分切除术并且术前行CTA检查评估肾动脉变异情况的患者284例,所有患者术前均通过超声或者CT等影像学检查初步诊断为肾肿瘤。记录患者一般资料,观察其肾动脉变异情况及分型。结果 284例CTA检查均顺利完成,未发现不良反应。肾动脉变异总的发生率为39.3%,且男性肾动脉变异的发生率明显高于女性,但左右侧肾动脉变异发生率无明显差异。81.9%的肾脏由1支肾动脉供血,且肾动脉数量变异的发生率男性明显高于女性。副肾动脉的发生率为16.1%,且有66.7%的副肾动脉走行入肾脏的上极或者下极。结论肾血管三维成像技术能够清晰地显示肾动脉的解剖及变异情况,丰富了术前评估的内容,增强了术前评估的效果,提高了手术的安全性,可以作为肾部分切除术的常规术前检查。Objective To investigate the applicative value of three-dimensional angiography in the evaluation of renal artery variation before robotic-assisted laparoscopic partial nephrectomy （RALPN） and its significance. Methods The clinical data of 284 RALPN cases examined by computed tomographic angiography （CTA） during June 2013 and March 2017 were ret- rospectively analyzed. All patients were diagnosed as renal tumor by ultrasonography or CT before operation. The patients＇ general information was recorded and the variations of renal artery were observed. Results The CTA examinations were successfully completed without any complications. The total variation rate of renal artery was 39.3%,and the incidence was much higher in male than in female,but there was no significant difference in location. Up to 81.9% of the kidneys had one renal artery, and the incidence of number variation of renal artery was significantly higher in male than in female. The incidence of accessory renal artery was 16.1 %, 66.7% of which travelled to the upper or lower pole of the kidney. Conclusion The three- dimensional angiography can clearly show the variation of renal artery,which will enrich the content and improve the efficacy of preoperative evaluation. It can facilitate the safety of operation and as a result, can be used as a routine examination of RALPN preoperatively.

关 键 词：CT血管成像 肾动脉变异 肾部分切除术 机器人 

分 类 号：R697.32[医药卫生—泌尿科学]