肾动脉低温灌注联合腹腔镜肾部分切除术处理复杂肾肿瘤的初步经验

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摘要 目的:介绍肾动脉低温灌注联合腹腔肾部分切除术处理复杂肾肿瘤的初步经验。方法:2013年3月起,共收治复杂肾肿瘤患者14例,在肾动脉低温灌注下,7例采用腹腔镜经腹膜后入路行肾部分切术,7例采用da Vinci Si机器人经腹腔入路实施手术。所有术后均由同一术者完成。结果:14例患者中12例成功实施了肾动脉低温灌下的肾部分切除术,术中4例出现了动脉阻断不全,2例术中改为肾根治性切除术,无一例改为开放手术。12例肾部分切除术的患者术后出现轻度肾功能下降。结论:对于复杂肾脏肿瘤,肾动脉低温灌注联合腹腔镜肾部分切除术具有可行性和安全性,可有效减少根治性肾切除的发生和热缺血对肾脏的损害。

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	马鑫
	刘新
	郑涛
	史涛坪
	瓦斯里江·瓦哈甫
	俞鸿凯
	宋鹏
	张旭

关键词 ：低温灌注, 后腹腔镜, 机器人,肾部分切除术

Abstract：Objective:To introduce our initial experience in using renal artery cold perfusion in laparoscopic partial nephrectomy for complex renal tumor. Methods:From March 2013, 14 patients with complex renal tumor underwent partial nephrectomy combined with renal artery cold perfusion. The operations were carried out by the same surgeon using laparoscopic retroperitoneal approach (n=7) and robotic transperitoneal approach (n=7) . Results:Partial nephrectomy was successfully performed on 12 patients. incomplete arterial block occurred in 4 patients, and 2 patients underwent conversion to radical nephrectomy. There was no conversion to open surgery in all cases. Additionally, a mild renal dysfunction was identified in the 12 patients who underwent partial nephrectomy. Conclusions:Combination of renal artery cold perfusion with laparoscopic partial nephrectomy is feasible and safe for complex renal tumor. It can reduce the incidence of radical nephrectomy, as well as the damage of warm ischemia to renal function.

Key words： cold perfusion retroperitoneal laparoscopic robotic partial nephrectomy

收稿日期: 2014-03-06

ZTFLH:

R737.1

基金资助:国家高技术研究发展计划(2012AA021100)

通讯作者: 张旭,xzhang@foxmail.com

引用本文:

马鑫,刘新,郑涛,史涛坪,瓦斯里江·瓦哈甫,俞鸿凯,宋鹏,张旭. 肾动脉低温灌注联合腹腔镜肾部分切除术处理复杂肾肿瘤的初步经验[J]. 微创泌尿外科杂志, 2018, 7(s1): 5-.
Ma Xin,Liu Xin,Zheng Tao,Shi Taoping,Wasilijiang·Wahafu,Yu Hongkai,Song Peng,Zhang Xu. Combination of renal artery cold perfusion with laparoscopic partial nephrectomy for complex renal tumor: our initial experience. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(s1): 5-.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1387.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2018/V7/Is1/5

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