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在腹腔镜肾部分切除术中使用自固定倒刺缝线可保留较好的肾功能:一项PADUA评分匹配对照研究

The use of self-retaining barbed suture preserves superior renal function during laparoscopic partial nephrectomy: a PADUA score matched comparison.

作者信息

Liu Wentao, Chen Minfeng, Zu Xiongbing, Li Yuan, He Wei, Tong Shiyu, Lei Ye, Qi Lin

机构信息

1 Department of Urology, The Second Xiangya Hospital of Central South University , Changsha, Hunan, China .

出版信息

J Laparoendosc Adv Surg Tech A. 2015 Feb;25(2):130-4. doi: 10.1089/lap.2014.0302.

Abstract

INTRODUCTION

To evaluate the efficacy and safety of self-retaining barbed suture (SRBS) application during laparoscopic partial nephrectomy (LPN), by assessing perioperative outcomes.

MATERIALS AND METHODS

Data from consecutive patients who underwent retroperitoneal LPN from January 2008 to December 2013 were retrospectively collected. Patients were divided into two groups according to suture techniques for renorrhaphy: the sliding clip technique and SRBS. The SRBS cases (Group 2 [G2]) were 1:1 matched with cases in the sliding clip group (Group 1 [G1]) for the PADUA score. Patient characteristics, perioperative outcomes, and renal function changes were compared between the groups.

RESULTS

In total, 41 patients in G1 and 41 patients in G2 successfully underwent LPN. Patient characteristics, operative time, and complication rate were similar for both groups. Mean warm ischemia time was significantly shorter for the SRBS group (G1 versus G2, 27.5 versus 20.7 minutes; P<.05). The estimated blood loss was similar in both groups. An improved early affected renal function recovery was observed in the SRBS group (percentage of glomerular filtration rate reduction for G1 versus G2, 29% versus 20.8%; P<.05).

CONCLUSIONS

The SRBS application offers an effective and safe renal parenchyma repair. In addition, SRBS appears to significantly minimize the warm ischemia injury and results in superior short-term renal function preservation.

摘要

引言

通过评估围手术期结果,评价腹腔镜肾部分切除术(LPN)中应用自固定倒刺缝线(SRBS)的有效性和安全性。

材料与方法

回顾性收集2008年1月至2013年12月行腹膜后LPN的连续患者的数据。根据肾缝合技术将患者分为两组:滑动夹技术组和SRBS组。SRBS组(第2组[G2])与滑动夹组(第1组[G1])的PADUA评分进行1:1匹配。比较两组患者的特征、围手术期结果和肾功能变化。

结果

G1组41例患者和G2组41例患者成功接受了LPN。两组患者的特征、手术时间和并发症发生率相似。SRBS组的平均热缺血时间明显更短(G1组与G2组,27.5分钟对20.7分钟;P<0.05)。两组的估计失血量相似。SRBS组观察到早期患肾功能恢复有所改善(G1组与G2组肾小球滤过率降低百分比,29%对20.8%;P<0.05)。

结论

应用SRBS可实现有效且安全的肾实质修复。此外,SRBS似乎能显著减少热缺血损伤,并在短期肾功能保留方面表现更优。

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