Esposito C, Iaquinto M, Escolino M, Farina A, La Manna A, Savanelli A, Settimi A, Di Mezza A
"Federico II" Pediatric Surgery University of Naples, Naples, Italy -
Minerva Urol Nefrol. 2014 Jun;66(2):101-5.
The aim of study was to retrospectively analyze our series of total and partial retroperiotoneoscopic nephrectomies performed in the last 5 years.
Twenty-two procedures were performed, 20 patients underwent nephrectomy and 2 patients underwent partial nephrectomy. The 20 patients who underwent nephrectomy were divided in 2 groups: group 1 (G1) patients-1-10, for whom we performed the procedure using monopolar coagulation, and group 2 (G2) patients 11-20 for whom we used a new hemostatic device to perform dissection and hemostasis. The results were analyzed using χ2 test. The results of partial nephrectomies were analyzed separately.
No conversion were reported. We analyzed 6 parameters to compare the results: operative time (OT), estimated blood loss (EBL), need for transfusion (NT), complications, time to oral intake (TOI), hospital stay (HS). OT in G1 was in median 85 minutes, in G2 65 minutes (P=0.004); EBL was 15 mL for G1 and 5 mL for G2 (P=0.000.), NT was not necessary in both, in G1 we had 2 complications and 1 complication in G2; TOI was day 1 for both groups; median HS was 3 days for both. As for heminephrectomy, OT was 120 and 140 min, EBL 30 mL in both, NT not necessary, TOI was 1 day and HS 4 and 5 days respectively.
Our study shows that the use of a new hemostatic devices reduce significantly OT and EBL in children underwent renal ablative surgery for benign pathologies compared with the use of monopolar coagulation.
本研究的目的是回顾性分析我们在过去5年中进行的一系列完全和部分后腹腔镜肾切除术。
共进行了22例手术，20例患者接受了肾切除术，2例患者接受了部分肾切除术。接受肾切除术的20例患者分为两组：第1组（G1）患者1 - 10号，我们使用单极电凝进行手术；第2组（G2）患者11 - 20号，我们使用一种新的止血装置进行解剖和止血。结果采用χ2检验进行分析。部分肾切除术的结果单独进行分析。
未报告中转情况。我们分析了6个参数以比较结果：手术时间（OT）、估计失血量（EBL）、输血需求（NT）、并发症、经口进食时间（TOI）、住院时间（HS）。G1组的OT中位数为85分钟，G2组为65分钟（P = 0.004）；G1组的EBL为15 mL，G2组为5 mL（P = 0.000）；两组均无需输血，G1组有2例并发症，G2组有1例并发症；两组的TOI均为术后第1天；两组的HS中位数均为3天。至于半肾切除术，OT分别为120分钟和140分钟，EBL均为30 mL，无需输血，TOI为术后1天，HS分别为4天和5天。
我们的研究表明，与使用单极电凝相比，在因良性病变接受肾脏消融手术的儿童中，使用新的止血装置可显著减少手术时间和估计失血量。
