Doerfler Arnaud, Oitchayomi Abeni, Tillou Xavier
Department of Urology and Transplantation, Caen University Hospital, Caen, France.
Department of Urology and Transplantation, Caen University Hospital, Caen, France.
Urology. 2014 Nov;84(5):1240-2. doi: 10.1016/j.urology.2014.07.025. Epub 2014 Sep 18.
To describe a simple method for ensuring surgical margins during laparoscopic partial nephrectomy (PN).
A study was done at our institution from October 2013 to March 2014 for all patients undergoing laparoscopic PN for T1 renal tumors. Before tumor removal, intraoperative ultrasonography (US) localization was performed. The tumor was then removed with a standardized minimal healthy tissue margin technique. Immediately after removal and before performing hemostasis of the kidney, the specimen was placed into a laparoscopic endobag filled with saline solution. The laparoscopic probe was then placed into the endobag and a sequential ultrasonographic scan was performed to evaluate if the tumor's pseudocapsule was respected.
Twelve patients were included in our study. Mean warm ischemia time was 19 ± 3 minutes. Mean US examination was 42 ± 9 seconds. US analysis of surgical margins was negative in all except 1 patient. The final histologic examination of all specimens confirmed US results with a 100% correlation.
We describe an original, simple, and cost-effective method for ensuring surgical margins during laparoscopic PN with a moderate increase in warm time ischemia.
描述一种在腹腔镜肾部分切除术(PN)中确保手术切缘的简单方法。
2013年10月至2014年3月在我们机构对所有因T1期肾肿瘤接受腹腔镜PN的患者进行了一项研究。在切除肿瘤前,进行术中超声(US)定位。然后采用标准化的最小健康组织切缘技术切除肿瘤。切除后立即且在对肾脏进行止血前,将标本放入充满盐溶液的腹腔镜内袋中。然后将腹腔镜探头放入内袋并进行连续超声扫描,以评估肿瘤假包膜是否得到保留。
我们的研究纳入了12例患者。平均热缺血时间为19±3分钟。平均超声检查时间为42±9秒。除1例患者外,所有患者的手术切缘超声分析均为阴性。所有标本的最终组织学检查证实超声结果,相关性为100%。
我们描述了一种原始、简单且经济有效的方法,可在腹腔镜PN期间确保手术切缘,同时热缺血时间适度增加。