Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
Biomed Res Int. 2017;2017:1849649. doi: 10.1155/2017/1849649. Epub 2017 May 29.
To evaluate the feasibility of an internal suspension technique in retroperitoneal laparoscopic partial nephrectomy for the management of renal ventral tumors.
Between January 2013 and July 2016, a total of 145 patients underwent retroperitoneal laparoscopic partial nephrectomy with or without internal suspension technique. For patients who underwent internal suspension technique, the surgeons preserved the external fat of the renal tumor as a suspension traction measure when separating the kidney. Propensity score matching (PSM) was performed according to age, gender, body mass index, tumor size, tumor location, and RENAL nephrometry score. Patient characteristics and intraoperative and postoperative outcomes were compared between the groups.
After PSM, 32 patients treated with the internal suspension technique were compared with 32 cases treated without such technique. Baseline characteristics were statistically similar for the cohorts. The use of our new technique resulted in shorter warm ischemia time (WIT: 15.0 versus 19.0 minutes, = .002) and tumor resection time (4.0 versus 7.5 minutes, < 0.001). The rate of WIT >25 minutes decreased (6.3% versus 25%, = .04) and the trifecta outcomes were significantly improved (87.5% versus 62.5%, = .02).
Internal suspension technique is a feasible and safe procedure in retroperitoneal laparoscopic partial nephrectomy for renal ventral tumors.
评估后腹腔镜肾部分切除术治疗肾前肿瘤的内置悬吊技术的可行性。
2013 年 1 月至 2016 年 7 月，共 145 例患者接受了后腹腔镜肾部分切除术，其中部分患者采用内置悬吊技术。对于采用内置悬吊技术的患者，外科医生在分离肾脏时保留肿瘤的外部脂肪作为悬吊牵引措施。根据年龄、性别、体重指数、肿瘤大小、肿瘤位置和 RENAL 肾肿瘤测量评分进行倾向评分匹配（PSM）。比较两组患者的一般资料、手术和术后结果。
PSM 后，32 例采用内置悬吊技术的患者与 32 例未采用该技术的患者进行了比较。两组患者的基线特征在统计学上相似。使用我们的新技术可缩短热缺血时间（WIT：15.0 分钟与 19.0 分钟， =.002）和肿瘤切除时间（4.0 分钟与 7.5 分钟， < 0.001）。WIT>25 分钟的发生率降低（6.3%与 25%， =.04），三联征结局明显改善（87.5%与 62.5%， =.02）。
内置悬吊技术是一种可行且安全的后腹腔镜肾部分切除术治疗肾前肿瘤的方法。
