Abstract：Objective: To investigate the feasibility and effectiveness of retroperitoneoscopic ruler measurement in the localization of complete endogenous renal cell carcinoma. Methods: From August 2018 to August 2020,10 patients with retroperitoneoscopic complete endocytic renal tumors were retrospectively analyzed. Retroperitoneoscopic ruler was used to measure and localize the tumors. STEP： 1. The distances between the upper and lower margins of the tumor and the upper and lower margins of the kidney were measured on CT or MRI before operation. 2. The projection points of the upper and lower margins of the tumor on the renal surface were estimated under retroperitoneoscope and marked by electrocautery. 3. The tumor was resected completely at the boundary of the circular area with the diameter of the marked projection of the upper and lower edges. The indexes of warm ischemia time, operation time, positive rate of incisal margin and renal function were analyzed. Results: All patients were successfully completed, no conversion to open or radical nephrectomy cases. The time of warm ischemia was （22.67 ± 5.58） min and the total time of operation was （174.50 ± 28.55） min. The serum creatinine level （28.95 ± 13.26） mmol/L was not significantly different from that before Operation （P < 0.05）, and the total renal function was not significantly different from that before operation. The patients were followed up for 1 year, and no recurrence or decrease of renal function was found. Conclusion: Retroperitoneoscopic nephrectomy is a safe and reliable method for the localization of Renal Carcinoma, and the patients recover quickly after surgery.
[1] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南(2014版).北京:人民卫生出版社,2014:6-10.
[2] 周颖琛,王燕,张洋,等.后腹腔镜与开放性肾根治性切除术治疗T2期肾癌的疗效差异Meta分析.国际泌尿系统杂志,2021,41(2):258-263.
[3] 陈旭,韦锦焕,周航,等.机器人辅助腹腔镜肾分支动脉分步阻断保留肾单位手术在治疗巨大复杂肾癌中的应用.中华腔镜泌尿外科杂志(电子版),2021,15(2):89-92.
[4] 东洁,徐维锋,纪志刚.单术者机器人辅助腹腔镜肾部分切除术的学习曲线.中华泌尿外科杂志,2021,42(4):246-251.
[5] 马潞林,刘茁.完全内生型肾肿瘤行腹腔镜肾部分切除术的术中定位、切缘阳性率和预后.现代泌尿外科杂志,2017,22(11):815-817,856.
[6] 周青英,黄达飞,郑定钦.腹腔镜根治性肾切除术治疗局限性肾癌的效果及安全性.浙江创伤外科,2018,23(1):72-73.
[7] 卢永良,肖毅,朱晓应,等.分层交叉预缝合镜头孔在机器人后腹腔肾部分切除术的应用.微创泌尿外科杂志,2020,9(4):217-220.
[8] 顾朝辉,冯勇杰,陈龙,等.区域NePhRO评分系统在腹腔镜下肾部分切除术治疗T1期肾癌中的应用.中华实验外科杂志,2021,38(2):364-366.
[9] 陈勇辉,吴小荣,陈伟,等.后腹腔镜下肾部分切除术在完全内生型肾肿瘤治疗中的应用.中华泌尿外科杂志,2016,37(10):726-729.
[10] ZAPALA PN.Open partial nephreetomy for entirely intraparenehymal tunloIN: a matched case contr01 study of oncologic outconle and complication rate [J]. Int Braz J Ur01, 2017,43(12):209-215.
[11] 王强,王保军,王云鹏,等.T2a期局限性肾癌患者临床、病理特征描述及肿瘤转移影响因素分析.微创泌尿外科杂志,2020,9(1):12-18.
[12] NADU A, GOLDBERG H, LUBIN M, et al.Laparoscopic partial nephrectomy(LPN)for totally intrarenal tunlouIN [J]. BJU Int, 2013,112(15):E82-E86.
[13] UKIMURA O, NAKAMOTO M, GILL IS.Three-dimen-sional Reconstruction of renovascular-tumor anatomy to facilitate zero-ischemia partial nephrectomy. Eur Urol, 2012,61(1):211-217.
[14] CHEN YB, LI HL, WU DT, et al.Surgical planning and manual image fusion based on 3D model facilitate laparoscopic partial nephrectomy for intrarenal tumors. World J Urol, 2014,32(6):1493-1499.
[15] FURUKAWA J, MIYAKE H, TANAKA K, et al.Console-integrated real-time three-dimensional image overlay navigation for robot-assisted partial nephrectomy with selective arterial clamping: early single-centre experience with 17 cases. Int J Med Robot, 2014,10(4):385-390.
[16] 刘茁,孟一森,范宇,等.后腹腔镜下肾部分切除术治疗内生型肾肿瘤的临床分析.中华泌尿外科杂志,2015,36(10):726-731.
[17] 李南南,叶云林.腹腔镜肾部分切除术治疗T1a期肾门肿瘤的临床疗效评价.国际泌尿系统杂志,2021,41(2):340-342.
[18] 张志凌,李永红,董培,等.肾后唇或前唇切开肾部分切除术治疗靠近肾门的内生型肾癌的初步经验.中华泌尿外科杂志,2015,36(3):172-174.
[19] 蔡启亮,王准,董茜,等.后腹腔镜下保留肾单位手术治疗完全内生性肾肿瘤的初步经验.中华泌尿外科杂志,2017,38(2):84-87.
