Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Lasers Med Sci. 2022 Feb;37(1):471-477. doi: 10.1007/s10103-021-03284-3. Epub 2021 Mar 13.
Laser-supported laparoscopic partial nephrectomy is a promising new technique, but remains under experiment. We presented our single institutional experience of laparoscopic partial nephrectomy using the 980/1470-nm dual-diode laser system to investigate its feasibility, and oncological and functional outcomes. The study retrospectively evaluated 25 patients with small exophytic renal tumors, who underwent laparoscopic partial nephrectomy using a 980/1470-nm dual-diode laser. The demographics, surgical data, complications, pathological variables, oncological, and functional outcomes were reviewed. The changes in hemoglobin and estimated glomerular filtration rate (eGFR) before and after surgery were statistically analyzed. The investigators operated on a total of 25 patients. The off-clamping technique was performed for 23 cases, while the other two cases required renal artery clamping due to unsatisfactory hemostasis. The tumor diameter was 24.6± 6.2 mm, and the mean operative time was 104.4± 23.4 min. The median estimated intraoperative blood loss (EBL) was 100 ml (range 50-600 ml). No major complications (Clavien-Dindo >II) occurred perioperatively. The mean change in hemoglobin before and after the operation was 9 g/l, with a P value of <0.001. The mean decrease in eGFR from before the surgery to the 6-month follow-up was 1.4 ml/min, with a P value of 0.463. The postoperative histopathology evaluation did not demonstrate a positive surgical margin. No recurrence or metastasis was found during the follow-up (mean 24 months). Laparoscopic partial nephrectomy using a 980/1470 nm dual-diode laser appears to be a feasible and oncological satisfactory technique for the treatment of small renal mass (SRM), with the advantages of reducing warm ischemia time.
激光辅助腹腔镜肾部分切除术是一种很有前途的新技术，但仍处于实验阶段。我们介绍了我们机构使用 980/1470nm 双二极管激光系统进行腹腔镜肾部分切除术的单一经验，以研究其可行性、肿瘤学和功能结果。该研究回顾性评估了 25 例接受腹腔镜肾部分切除术的小外生肾肿瘤患者，使用 980/1470nm 双二极管激光。评估了患者的人口统计学、手术数据、并发症、病理变量、肿瘤学和功能结果。对手术前后血红蛋白和估算肾小球滤过率（eGFR）的变化进行了统计学分析。研究者总共对 25 例患者进行了手术。23 例采用无夹闭技术，另外 2 例由于止血效果不理想需要肾动脉夹闭。肿瘤直径为 24.6±6.2mm，平均手术时间为 104.4±23.4min。中位估计术中出血量（EBL）为 100ml（范围 50-600ml）。围手术期无重大并发症（Clavien-Dindo > II）。术前和术后血红蛋白平均变化 9g/L，P 值<0.001。术前至术后 6 个月 eGFR 平均下降 1.4ml/min，P 值为 0.463。术后组织病理学评估未见切缘阳性。随访期间（平均 24 个月）无复发或转移。使用 980/1470nm 双二极管激光的腹腔镜肾部分切除术对于治疗小肾肿瘤（SRM）似乎是一种可行的、肿瘤学上满意的技术，其优势在于减少热缺血时间。
