CAJ | 학술논문

目的探索安全有效、简单易行的后腹腔镜下肾脏低温保护技术.方法拟行后腹腔镜下保留肾单位手术患者22例,分为研究组和对照组.研究组在后腹腔镜肾脏低温下行保留肾单位手术;对照组行常规后腹腔镜下保留肾单位手术.比较两组患者肾脏温度和直肠温度变化以及手术前后肾功能变化.结果 22例患者手术顺利;术后无继发出血、感染及漏尿.研究组冷缺血时间为(47.2±3.8)min,平均最低肾脏温度为(17.73±0.91)℃.研究组术前ECT示患肾肾小球滤过率(GFR)为(30.57±4.07) ml/min,术后1个月患肾GFR为(20.92 ± 4.49) ml/min.对照组术前ECT示患肾GFR为(30.65±5.45) ml/min,术后1个月患肾GFR(17.90±3.50) ml/min.患者术后随访1 ～16个月,未见局部复发、无转移.结论后腹腔镜下肾脏低温保护技术简单易行、效果确切.
목적 탐색안전유효、간단역행적후복강경하신장저온보호기술.방법 의행후복강경하보류신단위수술환자22례,분위연구조화대조조.연구조재후복강경신장저온하행보류신단위수술;대조조행상규후복강경하보류신단위수술.비교량조환자신장온도화직장온도변화이급수술전후신공능변화.결과 22례환자수술순리;술후무계발출혈、감염급루뇨.연구조랭결혈시간위(47.2±3.8)min,평균최저신장온도위(17.73±0.91)℃.연구조술전ECT시환신신소구려과솔(GFR)위(30.57±4.07) ml/min,술후1개월환신GFR위(20.92 ± 4.49) ml/min.대조조술전ECT시환신GFR위(30.65±5.45) ml/min,술후1개월환신GFR(17.90±3.50) ml/min.환자술후수방1 ～16개월,미견국부복발、무전이.결론 후복강경하신장저온보호기술간단역행、효과학절.
Objective Development of a new retroperitoneal laparoscopic technology which can keep the kidney in cold ischemia and has the characteristics of safety,effective and simplicity.Methods Twenty two patients who needs to do the retroperitoneal laparoscopic nephron sparing suygery were divided into two groups.In research group,we did the retroperitoneal laparoscopic nephron sparing surgery with hypothermic renal artery perfusion in situ.In the control group,we did the same as well except the renal hypothermia.Compared with the renal temperature and the rectal temperature during the surgery,and the glomerular filtration rate (GFR) of both bilateral kidney and affected side kidney before and after the surgery.Results All the surgery were done successfully in the patients of both groups.And no post-operative bleeding,inflammation and leakage of urine was found.In the research group,the average Cold ischemia time was (47.2 ±3.8) min,the average minimum renal temperature was (17.73 ±0.91) ℃.In the research group,the average value of affected side kidney GFR was (30.57 ± 4.07) ml/min before the surgery ; the average value of affected side kidney GFR was (20.92 ± 4.49) ml/min 1 month after the surgery.In the control group,the average value of affected side kidney GFR was (30.65 ± 5.45) ml/min before the surgery; the average value of affected side kidney GFR was (17.90 ± 3.50) ml/min 1 month after the surgery.The follow-up time was 1-16 months without local recurrence and metastasis.Conclusion We found that our new equipment with circumfusion system of ice saline can keep the kidney in cold ischemia,it was easy-to-use and efficient.