Naito S, Nakashima M, Kimoto Y, Nakamura M, Kotoh S, Tanaka M, Kumazawa J
Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Urol. 1998 Mar;159(3):960-2.
At partial nephrectomy there is a risk of excessive blood loss, which necessitates transfusion and also results in renal function deterioration when a vascular clamp is used. We evaluated the usefulness of a microwave tissue coagulator for partial nephrectomy for renal cell carcinoma.
Partial nephrectomy was performed without renal pedicle clamping using a microwave tissue coagulator in 4 patients with a small kidney tumor.
In 3 of the 4 patients partial nephrectomy was successful using a microwave tissue coagulator without renal pedicle clamping. Mean operative time and blood loss were 203 minutes and 153 ml., respectively, and there were no significant complications. In the remaining case partial kidney resection was also performed without any complications. However, nephrectomy was required due to possible incomplete tumor resection.
Partial nephrectomy using a microwave tissue coagulator can be safe and successful without renal pedicle clamping. However, the insertion line of the microwave electrode must be carefully determined for resection to be curative and safe, just as when making the cut line for conventional partial nephrectomy or tumor enucleation.
在部分肾切除术中存在失血过多的风险,这需要输血,并且当使用血管夹时还会导致肾功能恶化。我们评估了微波组织凝固器在肾细胞癌部分肾切除术中的实用性。
在4例患有小肾肿瘤的患者中,使用微波组织凝固器在不夹闭肾蒂的情况下进行了部分肾切除术。
4例患者中有3例使用微波组织凝固器在不夹闭肾蒂的情况下成功进行了部分肾切除术。平均手术时间和失血量分别为203分钟和153毫升,且无明显并发症。在其余1例病例中也进行了部分肾切除术,无任何并发症。然而,由于可能存在肿瘤切除不完全的情况,需要进行肾切除术。
使用微波组织凝固器进行部分肾切除术在不夹闭肾蒂的情况下可以是安全且成功的。然而,为了实现根治性和安全性切除,必须像在进行传统部分肾切除术或肿瘤剜除术的切割线时一样,仔细确定微波电极的插入线。