Retroperitoneal laparoscopic partial nephrectomy with segmental renal artery blocking for small renal cancer (Report of 39 cases)

doi:10.3969/j.issn.1009-976X.2014.05.023

Abstract

Abstract: 【Abstract】〓Objective〓To evaluate the curative effect and the safety of retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping for small renal cancer. Methods〓Thirty-nine cases were selected, at the age of 39-86, the average age 58±3.20. Tumor occurred in the left kidney and right kidney had 20 cases and 19 cases, and all were solitary. Tumor located in the upper pole,lower pole arid middle kidney had 18,12,9 case,respectively. The maximum diameter of the tumor ranged from 2 to 5 cm, with an average of 3.5±0.6 cm. All the cases were underwent retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping. Statistical data of operational duration, blood loss, renal segmentary artery blockage duration and pre-operative complications were gathered. Results〓Thirty-nine cases were completed smoothly under retroperitoneal laparoscope. The operation duration ranged 65-110 min, and the average duration was 85±16 min. The time of segmental renal artery occlusion ranged 20-42 min, and the average time was 26±5 min. The blood loss was 10-50 ml, and the average loss was 25 ml. The preliminary follow-up showed no secondary bleeding, urinous infiltration and implantation. No significant changes in renal function after surgery. Conclusion Retroperitoneal laparoscopic partial nephrectomy with segmental renal artery clamping for small renal cancer possesses the advantages of security, exact effect, maximum protection of renal function, with a clear surgical field, and small trauma.

Key words: Renal neoplasm, Laparoscope, Nephron-sparing surgery

摘要： 【摘要】〓目的〓评估腹膜后入路腹腔镜肾段动脉阻断肾部分切除术治疗早期肾癌的疗效、安全性。方法〓选择39例肾肿瘤患者,其中男28例,女11例,年龄39~86岁,平均58±3岁。其中左肾肿瘤20例,右肾肿瘤19例;所有均为单发。肾上极肿瘤 18例,下极肿瘤 12例,中部肿瘤9例。肿瘤最大径2.0~5.0 cm,平均3.5±0.6 cm。所有病例在临时阻断肾段动脉后,行腹膜后入路腹腔镜下肾部分切除术。统计手术时间、术中出血量、肾段动脉阻断时间及围术期并发症。结果〓39例手术均于后腹腔镜下顺利完成,手术时间65~110 min,平均85±16 min;肾段动脉阻断时间20~42 min,平均26±5 min;出血量10~50 mL,平均25 mL。无术后继发出血、尿外渗、种植;肾功能无显著变化。结论〓腹膜后入路腹腔镜肾段动脉阻断肾部分切除术治疗早期肾癌安全、效果确切;最大限度保护了肾功能,具有术野清晰、创伤小的优势。

关键词: 肾肿瘤, 腹腔镜, 肾部分切除术, 肾段动脉阻断

CLC Number:

Ｒ737.1

Chen Nanhui, Chen Zhiling, Huang Zhicheng, Peng Dong. Retroperitoneal laparoscopic partial nephrectomy with segmental renal artery blocking for small renal cancer (Report of 39 cases)[J]. Lingnan Modern Clinics in Surgery, 2014, 14(05): 583-586.

陈南辉陈智林黄志成彭栋. 腹膜后入路腹腔镜肾段动脉阻断肾部分切除术治疗早期肾癌(附39例报道)[J]. 岭南现代临床外科, 2014, 14(05): 583-586.

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