Steffens L
Eur Urol. 1986;12(4):260-4.
The aim of the described method of partial nephrectomy is to minimize injury to the kidney, if possible without causing unnecessary loss of blood, and without interrupting the arterial or venous blood flow during surgery. Use of a pedicle clamp, compressing forceps for the renal parenchyma or hypothermia is superfluous. Following pre- and intraoperative estimation of the dimensions of the area of the renal parenchyma to be removed, virtual hemostasis is achieved by applying a continuous U-shaped suture distal to the portion of the kidney to be resected, using an atraumatic chromic catgut suture. Total hemostasis in the area to be excised is attained with the aid of a second U-shaped suture, running parallel to the first but entering on the opposite renal margin. Following excision, the raw surfaces are then reapproximated by means of a continuous suture and thus sealed. To conclude the operation a temporary nephrostomy is inserted. The immediate and later follow-up results and the advantages and potential complications of the new technique are described in 112 consecutive patients presenting for treatment during a period of 12 years.
所述部分肾切除术方法的目的是尽量减少对肾脏的损伤，如有可能，不造成不必要的失血，且在手术过程中不中断动脉或静脉血流。使用肾蒂夹、肾实质压迫钳或低温是多余的。在术前和术中估计要切除的肾实质区域的尺寸后，使用无创伤铬制肠线缝合，在要切除的肾部分远端进行连续U形缝合，实现虚拟止血。通过第二条平行于第一条但从相对肾缘进入的U形缝合线，在切除区域实现完全止血。切除后，通过连续缝合使创面重新对合，从而封闭创面。手术结束时插入临时肾造瘘管。在12年期间接受治疗的112例连续患者中描述了新技术的近期和远期随访结果以及优点和潜在并发症。
