Feasibility and safety analysis of laparoscopic partial ischaemic nephrectomy for T1a stage renal carcinoma
Objective To analyze the feasibility and safety of laparoscopic zero ischemia par-tial nephrectomy,with the aim of exploring safe and effective methods for the surgical treatment of T1 a stage renal cancer with less impact on renal function.Methods Clinical data of 80 renal cancer pa-tients with T1a stage(tumor length diameter ≤4 cm,outward growth,away from the collecting sys-tem)who underwent laparoscopic partial nephrectomy(LPN)from July 2017 to December 2021 in the department of urology,Xuzhou Central Hospital were were retrospectively analyzed.According to whether renal artery was blocked during operation,the patients were divided into renal artery block group(renal artery block was routinely performed during operation)and zero ischemia group(renal ar-tery was not blocked during operation or only secondary blood vessels supplying tumor),with 40 cases in each group.The operative time,intraoperative blood loss,glomerular filtration rate(GFR)before and after operation and length of hospital stay were compared between the two groups.Results There was no intraoperative and postoperative blood transfusion in both groups,and the postoperative margins were negative.The intraoperative bleeding in the renal artery blockade group was lower than that in the zero ischemia group,and the differences were statistically significant(P＜0.001).The postoperative glomerular filtration rate at 24 h after operation was lower than that in the zero ischemia group,and the difference was statistically significant(P＜0.001).At 12-39 months of postoperative follow-up,the renal functions of the affected side were normal,and no tumor recurrence and metastasis occurred.Conclusions Laparoscopic partial nephrectomy with zero ischemia is a safe and effective surgical method for T1a renal cancer,which can reduce the renal thermal ischemia time to the greatest extent and protect renal function.
万方数据
维普
