本文選題：腎腫瘤　切入點(diǎn)：后腹腔鏡　出處：《北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年04期

【摘要】：目的:為降低后腹腔鏡入路的腹側(cè)腎部分切除術(shù)手術(shù)難度,減少手術(shù)風(fēng)險(xiǎn),總結(jié)歸納并發(fā)展后腹腔鏡入路腎部分切除術(shù)的腎蒂旋轉(zhuǎn)法及相關(guān)技術(shù)。方法:總結(jié)歸納并發(fā)展一整套針對(duì)腹側(cè)腎門區(qū)腎腫瘤的腎蒂旋轉(zhuǎn)法操作技術(shù),包括腎蒂旋轉(zhuǎn)、雙層縫合、早期開放動(dòng)脈等。該技術(shù)有助于實(shí)施后腹腔入路的腎部分切除術(shù),手術(shù)效果的評(píng)價(jià)由手術(shù)時(shí)間、熱缺血時(shí)間、術(shù)中出血量、手術(shù)切緣、術(shù)后腎功能、手術(shù)并發(fā)癥等組成。本研究回顧性分析中南大學(xué)湘雅醫(yī)院28例腹側(cè)腎腫瘤患者資料,其中15例為較復(fù)雜的腎門區(qū)腫瘤。結(jié)果:平均腫瘤大小為(3.8±0.5)cm,平均R.E.N.A.L評(píng)分為8(范圍7~9)。手術(shù)中平均熱缺血時(shí)間(23.8±4.7)min,縫合時(shí)間(26.2±6.5)min,估計(jì)失血量(139.1±54.0)m L,手術(shù)時(shí)間(124.1±12.1)min,中位住院天數(shù)為4 d。7例患者出現(xiàn)Clavien DindoⅠ~Ⅱ級(jí)并發(fā)癥,所有患者病理檢查均示切緣陰性,中位隨訪7個(gè)月無(wú)局部復(fù)發(fā)或遠(yuǎn)處轉(zhuǎn)移。結(jié)論:對(duì)于腹側(cè)腎腫瘤,尤其是位于腎門區(qū)的腎腫瘤,利用腎蒂旋轉(zhuǎn)法行后腹腔鏡下腎部分切除術(shù)是安全有效的;短時(shí)間隨訪結(jié)果較樂觀,但需長(zhǎng)時(shí)間隨訪。
[Abstract]:Objective: to reduce the difficulty and risk of retroperitoneal laparoscopic partial nephrectomy. Methods: to summarize and develop a set of renal pedicle rotation techniques for renal tumors in the ventral hilar area, including pedicle rotation and double suture. Early open artery, etc., this technique can be used to perform partial nephrectomy via retroperitoneal approach. The operative effect is evaluated by the time of operation, the time of hot ischemia, the amount of blood lost during operation, the margin of operation, the function of kidney after operation, and so on. The data of 28 patients with ventral renal tumor in Xiangya Hospital of Central South University were retrospectively analyzed. Results: the mean tumor size was 3. 8 鹵0. 5 cm and the average R.E.N.A.L score was 8 (range 7? 9). The mean warm ischemia time was 23. 8 鹵4. 7 min, the suture time was 26. 2 鹵6. 5 min, the estimated blood loss was 139.1 鹵54. 0 mL, the operation time was 124.1 鹵12. 1 min, and the median hospitalization time was 12. 1 鹵12. 1 min. Clavien Dindo grade 鈪，

本文編號(hào)：1696214