经腹腹腔镜下零缺血时间行肾部分切除术的初步经验  

Primary experience of intraperitoneal laparoscopic partial nephrectomy with zero ischemia time

作　　者：姜少军[1] 王斌[1] 谢克基[1] 蔡岳斌[1] 韦兴华[1] JIANG Shaojun;WANG Bin;XIE Keji;CAI Yuebin;WEI Xinghua(Department of Urology,Guangzhou First People′s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院泌尿外科,510180

出　　处：《实用医学杂志》2017年第12期1979-1981,共3页The Journal of Practical Medicine

摘　　要：目的:探讨经腹腹腔镜下不阻断肾动脉对T1a期周边型肾肿瘤行肾部分切除术的临床效果。方法:运用经腹途径腹腔镜下不阻断肾动脉对T1a期周边型肾肿瘤患者行肾部分切除术,观察手术时间、出血量、并发症等并总结初步的临床经验。结果:2014年10月至2017年1月期间共10例患者,男7例,女3例,均为T1a期周边型肾肿瘤。10例患者均顺利完成手术,其中1例因出血术野不清而暂时阻断肾动脉后完成手术,无中转开放。手术时间108~210 min,中位值135 min,术中估计失血量100~750 mL,中位值320 mL。随访2~24个月(中位值12个月),术后无肾脏继发出血、漏尿等并发症,未见肿瘤复发。结论:经腹腹腔镜下不阻断肾动脉对T1a期周边型肾肿瘤行肾部分切除术是可行的、安全的,能最大程度保护肾功能。Objective To evaluate the feasibility and clinical efficacy of intraperitoneal laparoscopicpartial nephrectomy for T1a peripheral renal neoplasms.Methods Intraperitoneal laparoscopic partial nephrectomywas performed without renal artery occlusion for T1a peripheral peripheral renal neoplasms.The operative time,bleeding volume and complications were observed and the clinical experience was summarized.Results From October2014to January2017,there were10patients:7males and3females.All patients had T1a peripheral renaltumors.10patients underwent operation successfully,of which1case developed temporarily blocked renal arteryin the surgery due to hemorrhage.There was no referral during surgeries.The operative duration was108to210min,with a median of135min.The estimated blood loss was100to750mL,with a median of320mL.Followedup duration was2to24months(median12months),there were not postoperative renal secondary bleeding,leakage and other complications.No recurrence of tumor was found.Conclusion It is feasible and safe to exerciseintraperitoneal laparoscopic partial nephrectomy without renal artery occlusion in the treatment of T1a peripheralrenal tumors,which can protect renal function to the greatest extent.

关 键 词：肾脏肿瘤 腹腔镜 零缺血 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]