Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai, 200001, China.
Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200001, China.
Asian J Surg. 2024 Jan;47(1):216-221. doi: 10.1016/j.asjsur.2023.07.077. Epub 2023 Aug 12.
To investigate the safety and efficacy of three-dimensional reconstruction of renal tumor vessels to guide laparoscopic partial nephrectomy of hilar tumors and non-hilar tumors under zero ischemia.
The clinical data of 82 patients with renal cancer who underwent zero ischemia retroperitoneal laparoscopic partial nephrectomy in the department of urology of our hospital from January 2018 to January 2021 were retrospectively reviewed. The patients were divided into hilar group and non-hilar group. The clinical data of all patients were statistically analyzed by t-test or χ.
There was no significantly difference in gender, age, tumor diameter and pathological stage between hilar and non-hilar tumor group. Most of the target vessels in the hilar tumor group were single targets, while most of the target vessels in the non-hilar tumor group were multiple targets (P<0.05). There was no significantly difference between the groups for mean operative time and length of stay. But hilar tumor group had significantly longer operation time (109.3 ± 9.2 vs. 90.3 ± 9.5 min, p<0.001). There was no significant difference in renal GFR and serum creatinine between the two groups. Hilar tumor group had no significantly difference of change of creatinine and GFR at post-operative 6 and 12 months as compared with non-hilar tumor group. There were no bleeding, urinary leakage, infection and other related complications in the two groups after 1 month follow-up. After 12 months of follow-up, there was no tumor recurrence and metastasis in the two groups.
The application of three-dimensional renal tumor vascular reconstruction technology can better realize laparoscopic zero ischemia nephron sparing surgery. The target vessels of patients with hilar, single and early renal cancer are easier to find, which is more suitable for three-dimensional renal tumor vascular reconstruction technology to implement laparoscopic zero ischemia nephron sparing surgery.
探讨三维重建肾肿瘤血管指导零缺血腹腔镜肾部分切除术治疗肾门肿瘤和非肾门肿瘤的安全性和有效性。
回顾性分析我院泌尿外科 2018 年 1 月至 2021 年 1 月行零缺血后腹腔镜肾部分切除术的 82 例肾癌患者的临床资料。将患者分为肾门组和非肾门组。采用 t 检验或 χ ²检验对所有患者的临床资料进行统计学分析。
肾门组和非肾门组患者性别、年龄、肿瘤直径、病理分期比较差异无统计学意义。肾门组肿瘤靶血管多为单支，而非肾门组肿瘤靶血管多为多支（P<0.05）。两组平均手术时间和住院时间比较差异无统计学意义。但肾门组手术时间明显较长（109.3±9.2 比 90.3±9.5 min，P<0.001）。两组术后 6 个月和 12 个月的肾小球滤过率（GFR）和血清肌酐比较差异均无统计学意义。肾门组术后 6 个月和 12 个月的肌酐和 GFR 变化与非肾门组比较差异均无统计学意义。两组术后 1 个月随访均无出血、漏尿、感染等相关并发症。两组随访 12 个月均无肿瘤复发转移。
三维肾肿瘤血管重建技术的应用可更好地实现腹腔镜零缺血肾部分切除术。肾门、单发、早期肾癌患者的靶血管更容易找到，更适合三维肾肿瘤血管重建技术实施腹腔镜零缺血肾部分切除术。
