Song Yao, Pang Songqiang, Yang Jinqiang, Li Sen, He Yaqiang, Luo Gongtang
Department of Urology, Shunyi Hospital, No. 3, Guangming South Street, Shunyi District, Beijing 101300, China.
Evid Based Complement Alternat Med. 2021 Oct 16;2021:2283727. doi: 10.1155/2021/2283727. eCollection 2021.
To explore the situation of 61 patients with renal tumors who underwent retroperitoneal laparoscopic nephron-sparing surgery (RLNSS) and the factors affecting postoperative renal function.
A total of 61 patients with renal tumors who underwent RLNSS in our hospital from January 2018 to January 2021 were included in this study. All patients were treated with RLNSS. The clinical data of patients were recorded. Before operation and 3 months after operation, the change value of glomerular filtration rate (ΔGFR) was measured by the Gates method. Multivariate linear regression was used to analyze the related factors affecting postoperative renal function.
All 61 patients successfully completed the operation. The mean operative time was 60-150 min' average (98.75 ± 14.38) min. The estimated intraoperative blood loss was 20-310 ml' average (107.93 ± 68.55) ml. Intraoperative warm ischemia time (WIT) was 0-39 min, with an average of (21.16 ± 6.47) min. All patients' pathological margins were negative after operation. In all patients, there were 5 postoperative complications, including 2 cases of renal wound bleeding (3.28%), 1 case of hematuria (1.64%), 1 case of urinary fistula (1.64%), and 1 case of subcutaneous emphysema (1.64%). There were significant differences in tumor diameter, preoperative GFR, operation time and WIT ( < 0.05). Multivariate analysis showed that tumor diameter, preoperative GFR, and WIT were all factors affecting the postoperative renal function of patients with RLNSS ( < 0.05).
RLNSS has a good curative effect on patients with renal tumor, and tumor diameter, preoperative GFR, and WIT were all factors affecting the postoperative renal function of patients with RLNSS.
探讨61例行后腹腔镜保留肾单位手术（RLNSS）的肾肿瘤患者的情况及影响术后肾功能的因素。
本研究纳入2018年1月至2021年1月在我院行RLNSS的61例肾肿瘤患者。所有患者均接受RLNSS治疗。记录患者的临床资料。术前及术后3个月采用Gates法测量肾小球滤过率（ΔGFR）的变化值。采用多因素线性回归分析影响术后肾功能的相关因素。
61例患者均成功完成手术。平均手术时间为60 - 150分钟，平均（98.75 ± 14.38）分钟。估计术中出血量为20 - 310毫升，平均（107.93 ± 68.55）毫升。术中热缺血时间（WIT）为0 - 39分钟，平均（21.16 ± 6.47）分钟。所有患者术后病理切缘均为阴性。所有患者术后发生5例并发症，包括肾创面出血2例（3.28%）、血尿1例（1.64%）、尿瘘1例（1.64%）、皮下气肿1例（1.64%）。肿瘤直径、术前GFR、手术时间和WIT差异有统计学意义（<0.05）。多因素分析显示，肿瘤直径、术前GFR和WIT均是影响RLNSS患者术后肾功能的因素（<0.05）。
RLNSS对肾肿瘤患者有良好的治疗效果，肿瘤直径、术前GFR和WIT均是影响RLNSS患者术后肾功能的因素。
