“Zero ischemia”laparoscopic partial nephrectomy by high-power GreenLight laser enucleation for renal carcinoma:A single-center experience  

作　　者：Xiang-Min Zhang Ji-Dong Xu Jian-Min Lv Xiu-Wu Pan Jian-Wei Cao Jian Chu Xin-Gang Cui 

机构地区：[1]Department of Urology,Xinhua Hospital,Shanghai Jiaotong University,School of Medicine,Shanghai 200092,China [2]Department of Urology,Shanghai Baoshan Luodian Hospital,Shanghai 201908,China [3]Department of Urology,Gongli Hospital of The Second Military Medical University,Shanghai 200135,China [4]Department of Urology,Shanghai The Seventh People's Hospital,Shanghai 200137,China

出　　处：《World Journal of Clinical Cases》2022年第17期5646-5654,共9页世界临床病例杂志

基　　金：Supported by the Program of Shanghai Academic/Technology Research Leader,No.19XD1405100;the Clinical Research Plan of SHDC,No.SHDC2020CR4025;Hospital Funded Clinical Research,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.21XHDB06.

摘　　要：BACKGROUND Laparoscopic partial nephrectomy has been widely used in renal cell carcinoma treatment.The efficacy of GreenLight laser on Laparoscopic partial nephrectomy is still unknown.AIM To present the first series of laparoscopic partial nephrectomy(LPN)by GreenLight laser enucleation without renal artery clamping.Due to the excellent coagulation and hemostatic properties of the laser,laser-assisted LPN(LLPN)makes it possible to perform a“zero ischemia”resection.METHODS Fifteen patients with T1a exogenous renal tumors who received high-power GreenLight laser non-ischemic LPN in our hospital were retrospectively analyzed.All clinical information,surgical and post-operative data,complications,pathological and functional outcomes were analyzed.RESULTS Surgery was successfully completed in all patients,and no open or radical nephrectomy was performed.The renal artery was not clamped,leading to no ischemic time.No blood transfusions were required,the average hemoglobin level ranged from 96.0 to 132.0 g/L and no postoperative complications occurred.The mean operation time was 104.3±8.2 min.The postoperative removal of negative pressure drainage time ranged from 5.0 to 7.0 d,and the mean postoperative hospital stay was 6.5±0.7 d.No serious complications occurred.Postoperative pathological results showed clear cell carcinoma in 12 patients,papillary renal cell carcinoma in 2 patients,and hamartoma in 1 patient.The mean creatinine level was 75.0±0.8μmol/L(range 61.0-90.4μmol/L)at 1 mo after surgery,and there were no statistically significant differences compared with pre-operation(P>0.05).The glomerular filtration rate ranged from 45.1 to 60.8 mL/min,with an average of 54.0±5.0 mL/min,and these levels were not significantly different from those before surgery(P>0.05).CONCLUSION GreenLight laser has extraordinary cutting and sealing advantages when used for small renal tumors(exogenous tumors of stage T1a)during LPN.However,use of this technique can lead to the generation of excessive smoke.

关 键 词：GreenLight laser Zero ischemia Partial nephrectomy LAPAROSCOPY Renal tumor 

分 类 号：R737.11[医药卫生—肿瘤]