腹腔镜超声辅助腹腔镜肾部分切除术治疗复杂性肾肿瘤的疗效观察  

Treatment of Complicated Renal Tumor by Laparoscopic Ultrasonography-assisted Laparoscopic Partial Nephrectomy

作　　者：王卫民[1] 王勤章[1] 李应龙[1] 倪钊[1] 李强[1] 钱彪[1] WANG Wei-min;WANG Qin-zhang;LI Ying-long;NI Zhao;LI Qiang;QIAN Biao(Department of Urology,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院第一附属医院泌尿外科,新疆石河子832008

出　　处：《农垦医学》2017年第5期390-392,共3页Journal of Nongken Medicine

基　　金：新疆生产建设兵团杰出青年创新资金专项(2011CD002)

摘　　要：目的:探讨腹腔镜超声(LUS)在腹腔镜肾部分切除术中的应用价值。方法:2015年3月至2017年3月对10例复杂性肾肿瘤(R.E.N.A.L评分≥7)患者行LUS辅助腹腔镜肾部分切除术治疗,LUS术中对肿瘤的定位、大小及边界进行观察,记录患者手术时间、热缺血时间、术中出血量、术后病理切缘情况等指标。结果:6例行后腹腔镜肾部分切除术,4例行经腹腹腔镜肾部分切除术。肿瘤直径平均3.8cm(2.8~4.3cm),R.E.N.A.L评分平均8.2分(7~10分),手术时间平均102min(85~130min),热缺血时间平均28.3min(25~31 min),术中出血量平均60m L(30~150m L);所有患者术后病理检查证实切缘均阴性。结论:腹腔镜超声在腹腔镜肾部分切除术中能够确定肿瘤位置,提高了手术的安全性,有效地降低切缘阳性率,并适用于不同的手术入路。Objective:To discuss the clinical application of laparoscopic ultrasound(LUS)in laparoscopic partial nephrectomy for complicated renal tumor.Methods:Ten patients received laparoscopic ultrasonography assisted laparoscopic partial nephrectomy for complicated renal tumor(R.E.N.A.L score≥7)from2015to2017in our department.The location,size and boundary of tumor were active observed by LUS.And indicators such as operating time,blood loss,pathology,cutting edge and so on were assessed.Results:Six cases underwent retroperitoneal laparoscopic partial nephrectomy,four underwent transabdominal laparoscopic partial nephrectomy.The average tumor diameter of patients enrolled was3.2cm(2.8~4.3cm),and R.E.N.A.L nephrometry score was8.2(7~10),and warm ischemia time was28.3minutes(25~31min),and mean operative time was102minutes(85~130min),and blood loss was60mL(30~150mL).All patients were confirmed negativemargins with postoperative pathology.Conclusion:LUS can determine tumor location and guide the operative route,increase safety of laparoscopic partial nephrectomy,effectively reduce the positive margin rate,and apply to different operative route.

关 键 词：肾肿瘤 腹腔镜超声 肾部分切除术 

分 类 号：R737.11[医药卫生—肿瘤]