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超声引导下肾动脉球囊导管闭塞术用于复发性肾肿瘤的杂交部分肾切除术的初步经验

Initial Experience with Hybrid Partial Nephrectomy with Ultrasound-guided Balloon Catheter Occlusion of the Renal Artery for Recurrent Renal Tumors.

作者信息

Shi Xu, Yu Yang, Ye Tianrun, Yu Gan, Xu Bin, Zhang Zongbiao, Wang Shen, Liu Zheng, Chen Ke, Wang Shaogang, Li Heng

机构信息

Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Ultrasound, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Eur Urol Open Sci. 2024 Feb 1;60:47-53. doi: 10.1016/j.euros.2024.01.008. eCollection 2024 Feb.

Abstract

Repeat partial nephrectomy (PN) is an effective treatment in improving the prognosis for patients with recurrent renal cancer after initial PN. However, salvage PN (sPN) is inevitably associated with a higher rate of complications, largely because of intraperitoneal adhesions and fibrosis. Here we describe three initial cases for which recurrent renal tumors were treated with a novel minimally invasive approach, namely Ultrasound-guided Renal Artery Balloon catheter Occluded Hybrid Partial Nephrectomy (UBo-HPN).With laparoscopic ultrasound (LUS) guiding a Fogarty catheter to occlude the arterial blood supply, dissection of the renal hilum and most of the abdominal cavity can be avoided. UBo-HPN was successfully performed in three patients. One case of postoperative fever (Clavien-Dindo grade II) occurred, with no other complications. The mean operative time was 106 min, with a mean warm ischemia time of 21 min. UBo-HPN may be considered a safe and effective alternative for sPN, with a minimally invasive surgical footprint and better surgical outcomes.

摘要

重复部分肾切除术(PN)是改善初次PN后复发性肾癌患者预后的有效治疗方法。然而,挽救性PN(sPN)不可避免地伴随着更高的并发症发生率,主要是由于腹腔内粘连和纤维化。在此,我们描述了3例初次发病的复发性肾肿瘤患者采用一种新型微创方法进行治疗的病例,即超声引导下肾动脉球囊导管闭塞杂交部分肾切除术(UBo-HPN)。通过腹腔镜超声(LUS)引导Fogarty导管闭塞动脉血供,可以避免肾门和大部分腹腔的解剖。3例患者均成功实施了UBo-HPN。发生1例术后发热(Clavien-Dindo二级),无其他并发症。平均手术时间为106分钟,平均热缺血时间为21分钟。UBo-HPN可被认为是sPN的一种安全有效的替代方法,具有微创的手术切口和更好的手术效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36e3/10850398/467d7c32da93/gr1.jpg

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