The guiding significance of CTA for retrolaparoscopic partial nephrectomy
Objective To explore the value of computed tomography angiography(CTA)in valuating renal artery and renal vein variation as well as its guiding significance for retrolaparoscopic partial nephrectomy.Methods The clinical data of patients who underwent retrolaparoscopic partial nephrectomy in our hospital from September 2015 to June 2022 were retrospectively analyzed.According to whether CTA examination was performed,the patients were divided into control group(47 cases,routine examination before surgery)and observation group(77 cases,routine examination before surgery+CTA).The surgical effects of the two groups were compared.Results The operation time and renal artery blocking time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P＜0.05).Among the 124 patients,50 patients had renal artery variation,of which 36 cases were found by preoperative CTA,2 cases were found during surgery in the observation group,and the remaining 12 cases were found during surgery in the control group;the accuracy of CTA in diagnosing renal artery variation was 94.74％.Renal vein variation existed in 19 patients,all of which were detected by preoperative CTA and confirmed during operation;the accuracy of CTA in diagnosing renal vein variation was 100.00％.There were no significant differences in the total incidence of postoperative complications,postoperative drainage time and postoperative hospital stay between the two groups(P＞0.05);after operation,the levels of urea nitrogen and serum creatinine in both groups were lower than those before operation,and those in the observation group were lower than the control group(P＜0.05).Conclusion CTA can clearly observe the branch movement of the renal vascular variation,supplement the deficiency of conventional CT images in vascular imaging,save time for the selection of surgical protocols,and reduce the possibility of massive bleeding during the operation.However,in a small number of patients,CTA can not reflect the true renal artery situation,so it is necessary to perfect preoperative examination and develop individual surgical plans to reduce the occurrence of intraoperative accidents.
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