Perlin D V, Aleksandrov I V, Zipunnikov V P, Kargin K A
Urologiia. 2013 Jul-Aug(4):69-73.
Oncological outcomes of laparoscopic partial nephrectomy are no worse than those after open sparing operation for kidney cancer. However, laparoscopic procedures are accompanied by a longer warm ischemia. In order to reduce the ischemic injury, local ischemia by isolation and temporary clamping of the individual branches of the renal artery was used. From January 2009 to June 2012, 60 laparoscopic partial nephrectomies were performed in the clinic, including 34 resections with temporary clipping of renal artery and 26 resections with temporary clipping of secondary and tertiary segmental and subsegmental branches. Functions of affected kidney were evaluated before and after surgery in both groups of patients. At 3 months after surgery, significantly lower decline of the function of affected kidney was observed in patients who underwent resection with the use of local ischemia compared with patients who received the intervention accompanied by a temporary clamping the renal artery. Partial nephrectomy using local ischemia can significantly expand the indications for laparoscopic and retroperitoneoscopic sparing operation for renal cell cancer.
腹腔镜部分肾切除术的肿瘤学结果并不比开放性保肾手术治疗肾癌的结果差。然而，腹腔镜手术伴随着更长的热缺血时间。为了减少缺血损伤，采用了通过分离和临时夹闭肾动脉各分支进行局部缺血的方法。2009年1月至2012年6月，临床共进行了60例腹腔镜部分肾切除术，其中34例为肾动脉临时夹闭切除术，26例为二级、三级节段性和亚节段性分支临时夹闭切除术。两组患者均在手术前后评估患肾功能。术后3个月，与接受肾动脉临时夹闭干预的患者相比，采用局部缺血切除术的患者患肾功能下降明显更低。采用局部缺血的部分肾切除术可显著扩大腹腔镜和后腹腔镜保留肾单位手术治疗肾细胞癌的适应证。
