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本文引用的文献

1
Retroperitoneoscopic radical nephrectomy with a small incision for renal cell carcinoma: comparison with the conventional method.小切口后腹腔镜根治性肾切除术治疗肾细胞癌：与传统方法的比较
J Negat Results Biomed. 2011 Aug 16;10:11. doi: 10.1186/1477-5751-10-11.
2
Revised equations for estimated GFR from serum creatinine in Japan.日本基于血清肌酐估算肾小球滤过率的修订方程。
Am J Kidney Dis. 2009 Jun;53(6):982-92. doi: 10.1053/j.ajkd.2008.12.034. Epub 2009 Apr 1.
3
Improvement on parenchymal suturing technique in laparoscopic partial nephrectomy.腹腔镜肾部分切除术中实质缝合技术的改进
Int J Urol. 2008 Sep;15(9):854-5. doi: 10.1111/j.1442-2042.2008.02101.x.
4
Correlation between loss of renal function and loss of renal volume after partial nephrectomy for tumor in a solitary kidney.孤立肾肿瘤行部分肾切除术后肾功能丧失与肾体积丧失之间的相关性。
J Urol. 2008 Apr;179(4):1284-8. doi: 10.1016/j.juro.2007.11.071. Epub 2008 Feb 20.
5
Laparoscopic partial nephrectomy in patients with compromised renal function.肾功能受损患者的腹腔镜下部分肾切除术
Urology. 2008 Jun;71(6):1043-8. doi: 10.1016/j.urology.2007.11.022. Epub 2008 Feb 11.
6
Is renal warm ischemia over 30 minutes during laparoscopic partial nephrectomy possible? One-year results of a prospective study.
Eur Urol. 2007 Oct;52(4):1170-8. doi: 10.1016/j.eururo.2007.04.024. Epub 2007 Apr 11.
7
Open partial nephrectomy for tumor in a solitary kidney: experience with 400 cases.孤立肾肿瘤的开放性部分肾切除术：400例经验
J Urol. 2006 May;175(5):1630-3; discussion 1633. doi: 10.1016/S0022-5347(05)00991-2.
8
The impact of warm ischaemia on renal function after laparoscopic partial nephrectomy.热缺血对腹腔镜肾部分切除术后肾功能的影响。
BJU Int. 2005 Feb;95(3):377-83. doi: 10.1111/j.1464-410X.2005.05304.x.
9
Impact of temporary hilar clamping during laparoscopic partial nephrectomy on postoperative renal function: a prospective study.腹腔镜部分肾切除术中临时肾门阻断对术后肾功能的影响：一项前瞻性研究
J Urol. 2004 Jul;172(1):54-7. doi: 10.1097/01.ju.0000132125.78189.93.
10
Laparoscopic partial nephrectomy for renal tumor: single center experience comparing clamping and no clamping techniques of the renal vasculature.腹腔镜肾部分切除术治疗肾肿瘤：单中心比较肾血管阻断与非阻断技术的经验
J Urol. 2003 Feb;169(2):483-6. doi: 10.1097/01.ju.0000045225.64349.bf.

冷缺血开放性部分肾切除术、热缺血腹腔镜下部分肾切除术以及使用微波凝固的腹腔镜下部分肾切除术术后肾功能丧失情况的比较

Comparison of the loss of renal function after cold ischemia open partial nephrectomy, warm ischemia laparoscopic partial nephrectomy and laparoscopic partial nephrectomy using microwave coagulation.

作者信息

Kawahara Takashi, Sakata Ryoko, Kawahara Kimiko, Ito Hiroki, Miyoshi Yasuhide, Sano Futoshi, Nakaigawa Noboru, Uemura Hiroji, Yao Masahiro, Kubota Yoshinobu, Makiyama Kazuhide

机构信息

Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Department of Nephrology, International Goodwill Hospital, Yokohama, Japan.

出版信息

Curr Urol. 2013 Jan;6(3):118-23. doi: 10.1159/000343524. Epub 2012 Dec 21.

DOI:10.1159/000343524
PMID:24917728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3783315/
Abstract

PURPOSE

Nephron sparing surgery is an effective surgical option in patients with renal cell carcinoma. Laparoscopic partial nephrectomy involves clamping and unclamping techniques of the renal vasculature. This study compared the postoperative renal function of partial nephrectomy using an estimation of the glomerular filtration rate (eGFR) for a Japanese population in 3 procedures; open partial nephrectomy in cold ischemia (OPN), laparoscopic partial nephrectomy in warm ischemia (LPN), and microwave coagulation using laparoscopic partial nephrectomy without ischemia (MLPN).

MATERIALS AND METHODS

A total of 57 patients underwent partial nephrectomy in Yokohama City University Hospital from July 2002 to July 2008. 18 of these patients underwent OPN, 17 patients received MLPN, and 22 patients had LPN. The renal function evaluation included eGFR, as recommended by The Japanese Society of Nephrology.

RESULTS

There was no significant difference between the 3 groups in the reduction of eGFR. eGFR loss in the OPN group was significantly higher in patients that experienced over 20 minutes of ischemia time. eGFR loss in LPN group was significantly higher in patients that experienced over 30 minutes of ischemia time.

CONCLUSION

This study showed that all 3 procedures for small renal tumor resection were safe and effective for preserving postoperative renal function.

摘要

目的

保留肾单位手术是肾细胞癌患者有效的手术选择。腹腔镜下部分肾切除术涉及肾血管的夹闭和松开技术。本研究比较了在日本人群中，通过估计肾小球滤过率（eGFR）评估的三种手术方式下部分肾切除术后的肾功能；冷缺血下开放性部分肾切除术（OPN）、热缺血下腹腔镜部分肾切除术（LPN）以及无缺血的腹腔镜部分肾切除术联合微波凝固术（MLPN）。

材料与方法

2002年7月至2008年7月，共有57例患者在横滨市立大学医院接受了部分肾切除术。其中18例患者接受了OPN，17例患者接受了MLPN，22例患者接受了LPN。根据日本肾脏病学会的建议，肾功能评估包括eGFR。

结果

三组在eGFR降低方面无显著差异。在缺血时间超过20分钟的患者中，OPN组的eGFR损失显著更高。在缺血时间超过30分钟的患者中，LPN组的eGFR损失显著更高。

结论

本研究表明，对于小肾肿瘤切除的所有三种手术方式在保留术后肾功能方面都是安全有效的。