Homewood David, Tan Nicholas, Fay Tayla, Silagy Andrew, Lawrentschuk Nathan, Corcoran Niall M, Agarwal Dinesh K
Department of Urology, Western Health, Melbourne, Victoria, Australia.
Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Int J Urol. 2025 Apr;32(4):329-340. doi: 10.1111/iju.15658. Epub 2025 Mar 10.
Partial nephrectomy aims to provide both effective oncological management and renal function preservation. Surgical complications pertaining to the defect created during a partial nephrectomy include hemorrhage and urinary leak. Over time, approaches have advanced for managing the defect created during a partial nephrectomy. Herein, we explore techniques used for renorrhaphy in partial nephrectomy, its evolution and current state. We review the history of partial nephrectomy and the early techniques used to close the parenchymal defect, highlighting their advantages and disadvantages. The article then investigates the principles of renorrhaphy and the sliding clip technique. Modifications made to the sliding clip technique are depicted with illustrations. Single-layer versus double-layer closure and continuous versus interrupted sutures are evaluated. Non-renorrhaphy techniques, such as sealants and glues, used to seal the renal remnant are explored. By examining the evolution of renorrhaphy techniques, this article provides a comprehensive understanding of the improvements made in a key component of partial nephrectomy. We aim to provide novel insights towards better understanding the history and current state of renorrhaphy techniques in partial nephrectomy.
部分肾切除术旨在实现有效的肿瘤治疗和肾功能保留。与部分肾切除术过程中所造成的缺损相关的手术并发症包括出血和尿漏。随着时间的推移,处理部分肾切除术所造成缺损的方法不断进步。在此,我们探讨部分肾切除术中肾缝合术所使用的技术、其演变过程及现状。我们回顾部分肾切除术的历史以及用于闭合实质缺损的早期技术,突出它们的优缺点。本文接着研究肾缝合术的原则及滑动夹技术。文中配有插图描述了对滑动夹技术所做的改进。评估了单层缝合与双层缝合以及连续缝合与间断缝合的情况。还探讨了用于封闭肾残余创面的非肾缝合术技术,如密封剂和胶水。通过审视肾缝合术技术的演变,本文全面介绍了部分肾切除术这一关键环节所取得的进展。我们旨在提供新颖的见解,以便更好地了解部分肾切除术中肾缝合术技术的历史和现状。