Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, School of Medicine, Orbassano, Turin, Italy.
Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, School of Medicine, Orbassano, Turin, Italy.
Eur Urol Focus. 2019 Jul;5(4):600-603. doi: 10.1016/j.euf.2017.08.006. Epub 2017 Aug 30.
The quantity of the preserved parenchyma after partial nephrectomy is the result of interplay among various factors: the unmodifiable preoperative quality of the renal parenchyma and some technical modifiable aspects. Among the modifiable factors able to influence the quantity, the suture technique has gained paramount importance. Indeed, nowadays there is a consensus suggesting that one of the main predictors of the ultimate renal function is the minimal parenchymal volume loss: this is the sum of the healthy parenchyma excised with the tumour and the portion of the parenchyma devascularised by the renorrhaphy. The historical aim of a good suture was to avoid bleeding and urine leakage. A modern suture after partial nephrectomy should minimise the ischaemic effect on the renal parenchyma whenever possible. This has to be carried out with precision and based on the vascular anatomy of the kidney. PATIENT SUMMARY: In this report, we tried to describe the best practice for the suturing of renal parenchyma after conservative surgical treatment for small renal tumours. Indeed, the suture after the resection of a renal mass should minimise the ischaemic effect on the renal tissue whenever possible, maximising the functional outcomes.
术前不可改变的肾实质质量和一些可改变的技术方面。在可改变的因素中，缝线技术具有至关重要的作用。事实上，目前有一个共识认为，最终肾功能的主要预测因素之一是最小的肾实质体积损失：这是切除肿瘤的健康实质与通过肾缝合术使实质去血管化的部分的总和。历史上，良好缝线的目的是避免出血和尿液漏出。在进行部分肾切除术后，现代缝线应尽可能减少对肾实质的缺血影响。这必须精确进行，并基于肾脏的血管解剖结构。患者总结：在本报告中，我们试图描述小肾肿瘤保守性手术治疗后肾实质缝合的最佳实践。事实上，切除肾肿块后的缝合应尽可能减少对肾组织的缺血影响，最大限度地提高功能结果。
