Sönmez Mehmet Giray, Kara Cengiz
Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Department of Urology, Medical Park Ankara Hospital, Ankara, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2017 Sep;12(3):257-263. doi: 10.5114/wiitm.2017.67136. Epub 2017 Apr 11.
Laparoscopic minimally invasive partial nephrectomy (MIPN) is the preferred technique in renal surgery, especially T1 phase kidney tumours, and it is recommended for the protection of renal functions in methods that do not involve ischaemia.
To evaluate long-term renal functions of zero-ischaemia laparoscopic MIPN patients who underwent a modified sequential preplaced suture renorrhaphy technique.
In a total of 17 renal units in 16 patients with kidney tumours that were determined incidentally and did not cause any complaints, the masses were extracted via laparoscopic partial nephrectomy (LPN) using the modified sequential preplaced suture renorrhaphy technique. Creatinine and estimated glomerular filtration rate (eGFR) values of the patients were measured preoperatively and on the first day and after 12 months postoperatively, and the results were compared.
The differences between the pre- and postoperative values were statistically significant (p = 0.033, p = 0.045), but the changes in postoperative creatinine and eGFR values were clinically insignificant. While the differences between preoperative and first-day postoperative creatinine and eGFR values were found to be statistically significant (p = 0.039, p = 0.042, respectively), a statistically significant difference was not detected between preoperative and 12-month postoperative creatinine and eGFR values (p = 0.09, p = 0.065, respectively). The global percentage of functional recovery was measured as 92.5% on the first day and 95.9% at the 12 month.
The modified sequential preplaced suture renorrhaphy technique is an effective, reliable method for avoiding complications and preserving renal functions and nephrons in appropriate patients.
腹腔镜微创部分肾切除术（MIPN）是肾脏手术中的首选技术，尤其是对于T1期肾肿瘤，并且在不涉及缺血的方法中，推荐该技术用于保护肾功能。
评估采用改良序贯预置缝线肾缝合术的零缺血腹腔镜MIPN患者的长期肾功能。
在16例偶然发现且无任何不适主诉的肾肿瘤患者的总共17个肾单位中，采用改良序贯预置缝线肾缝合术通过腹腔镜部分肾切除术（LPN）切除肿块。术前、术后第1天和术后12个月测量患者的肌酐和估计肾小球滤过率（eGFR）值，并比较结果。
术前和术后值之间的差异具有统计学意义（p = 0.033，p = 0.045），但术后肌酐和eGFR值的变化在临床上无显著意义。虽然术前与术后第1天的肌酐和eGFR值之间的差异具有统计学意义（分别为p = 0.039，p = 0.042），但术前与术后12个月的肌酐和eGFR值之间未检测到统计学显著差异（分别为p = 0.09，p = 0.065）。功能恢复的总体百分比在术后第1天测量为92.5%，在12个月时为95.9%。
改良序贯预置缝线肾缝合术是一种有效、可靠的方法，可避免并发症，并在合适的患者中保留肾功能和肾单位。
