Hruby Stephan, Lusuardi Lukas, Jeschke Stephan, Janetschek Günter
Department of Urology and Andrology, Paracelsus Medical University, Salzburg, Austria.
Arch Esp Urol. 2013 Jan-Feb;66(1):139-45.
The purpose of this review is to provide an overview of the possibilities and drawbacks of the various possibilities of renal parenchymal cooling during laparoscopic partial nephrectomy and also give an outlook into future developments.
In January 2012 a PubMed Search using the search terms "partial nephrectomy, cooling," followed by a systematic and critical review was performed.
Renal cooling during laparoscopic partial nephrectomy is a feasible, safe and effective procedure to expand ischemia time up to over 60 minutes, without risking significant and long lasting deterioration of renal function. It can be of value in patients with an imperative indication for partial nephrectomy, like solitary kidneys, synchronous bilateral tumors or renal failure in the opposite kidney as well as for patients at risk for deterioration of renal function and in any situation, where you think to yourself that 20 minutes will be maybe not enough to finish the job technically. Renal arterial perfusion provides the clinically best-studied option in this situation followed by ice-cold saline irrigation. Other surface coolants look promising, but still lack clinical data.
本综述旨在概述腹腔镜部分肾切除术期间肾实质冷却的各种可能性及缺点，并展望未来的发展。
2012年1月，使用检索词“部分肾切除术，冷却”在PubMed上进行搜索，随后进行系统且批判性的综述。
腹腔镜部分肾切除术期间的肾冷却为可行、安全且有效的操作，可将缺血时间延长至60分钟以上，而不会有肾功能显著且持久恶化的风险。对于有迫切部分肾切除术指征的患者，如孤立肾、同步双侧肿瘤或对侧肾功能衰竭的患者，以及有肾功能恶化风险的患者，在任何你认为20分钟可能不足以完成手术操作的情况下，肾冷却都可能具有价值。在这种情况下，肾动脉灌注是临床研究最多的选择，其次是冰冷盐水灌注。其他表面冷却剂看起来很有前景，但仍缺乏临床数据。
