中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
18期
1275-1277
,共3页
腹腔镜%肾切除术%热缺血%肾肿瘤
腹腔鏡%腎切除術%熱缺血%腎腫瘤
복강경%신절제술%열결혈%신종류
Laparoscopes%Nephrectomy%Warm ischemia%Kidney neoplasms
目的 探讨一种新的肾血管阻断技术在腹腔镜肾部分切除术中的应用及临床价值.方法 2011年3-6月,对10例肾脏小肿瘤患者应用高选择性肾动脉分支阻断技术,行腹腔镜肾部分切除术.男6例,女4例,平均年龄(47±13)岁,平均肿瘤直径约(2.8±0.9)cm.观察手术时间、术中出血量、高选择性肾动脉分支阻断时间、引流管留置时间、术后住院天数、并发症及手术效果.结果 手术均顺利完成,平均手术时间( 101±23) min,术中中位出血量112 ml,术中平均高选择性肾动脉分支阻断时间(28± 6) min,无输血、中转开放手术病例.术中及术后无并发症,肾周引流管平均留置时间为(5.0±1.3)d,平均术后住院时间(8.0±0.8)d,术后随访时间(4.0±1.1)个月.病理回报4例肾血管平滑肌脂肪瘤；5例肾透明细胞癌,切缘阴性；1例肾乳头状细胞癌,切缘阴性.结论 高选择性肾动脉分支阻断技术是一种新的肾血管阻断技术,在肾部分切除术中安全有效,但需要长期随访及大宗病例研究.
目的 探討一種新的腎血管阻斷技術在腹腔鏡腎部分切除術中的應用及臨床價值.方法 2011年3-6月,對10例腎髒小腫瘤患者應用高選擇性腎動脈分支阻斷技術,行腹腔鏡腎部分切除術.男6例,女4例,平均年齡(47±13)歲,平均腫瘤直徑約(2.8±0.9)cm.觀察手術時間、術中齣血量、高選擇性腎動脈分支阻斷時間、引流管留置時間、術後住院天數、併髮癥及手術效果.結果 手術均順利完成,平均手術時間( 101±23) min,術中中位齣血量112 ml,術中平均高選擇性腎動脈分支阻斷時間(28± 6) min,無輸血、中轉開放手術病例.術中及術後無併髮癥,腎週引流管平均留置時間為(5.0±1.3)d,平均術後住院時間(8.0±0.8)d,術後隨訪時間(4.0±1.1)箇月.病理迴報4例腎血管平滑肌脂肪瘤；5例腎透明細胞癌,切緣陰性；1例腎乳頭狀細胞癌,切緣陰性.結論 高選擇性腎動脈分支阻斷技術是一種新的腎血管阻斷技術,在腎部分切除術中安全有效,但需要長期隨訪及大宗病例研究.
목적 탐토일충신적신혈관조단기술재복강경신부분절제술중적응용급림상개치.방법 2011년3-6월,대10례신장소종류환자응용고선택성신동맥분지조단기술,행복강경신부분절제술.남6례,녀4례,평균년령(47±13)세,평균종류직경약(2.8±0.9)cm.관찰수술시간、술중출혈량、고선택성신동맥분지조단시간、인류관류치시간、술후주원천수、병발증급수술효과.결과 수술균순리완성,평균수술시간( 101±23) min,술중중위출혈량112 ml,술중평균고선택성신동맥분지조단시간(28± 6) min,무수혈、중전개방수술병례.술중급술후무병발증,신주인류관평균류치시간위(5.0±1.3)d,평균술후주원시간(8.0±0.8)d,술후수방시간(4.0±1.1)개월.병리회보4례신혈관평활기지방류；5례신투명세포암,절연음성；1례신유두상세포암,절연음성.결론 고선택성신동맥분지조단기술시일충신적신혈관조단기술,재신부분절제술중안전유효,단수요장기수방급대종병례연구.
Objective To explore the feasibility and efficiency of new clamping technique of renal arterial branches during laparoscopic partial nephrectomy.Methods Between March and June 2011,10patients (6 males,4 females) with small renal tumor underwent laparoscopic partial nephrectomy with highly selective clamping of renal arterial branches.The mean age was (47 ± 13 ) years and the mean tumor size (2.8 ± 0.9 ) cm.Operative duration,estimated blood loss,time for highly selective clamping of renal arterial branches,postoperative hospital stay,indwelling duration of drainage tube and complications were recorded.Results The operations were successfully performed in all patients.The mean operative duration was (101 ±23) min,the mean estimated blood loss 112 ml and the mean time for the clamping of renal arterial branches (28 ± 6) min.There was neither blood transfusion nor conversion into open surgery.The mean indwelling duration of drainage tube was (5.0 ± 1.3 )days and the mean postoperative hospital stay (8.0 ±0.8)days.The recovery of all patients was uneventful.Conclusion Highly selective clamping of renal arterial branches is a new method of protecting renal function during laparoscopic partial nephrectomy.Further studies and a longer follow-up are warranted.
