新型双向倒钩免打结缝合线在肾门部肿瘤腹腔镜下肾部分切除术中的应用

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摘要 目的:评价新型双向倒钩免打结缝合线(QUILL SRS)在腹腔镜下肾门部肾肿瘤肾部分切除术中应用的安全性及效果。方法:回顾性分析后腹腔镜肾部分切除术治疗肾门部肾肿瘤共10例,均采用QUILL SRS缝线缝合肾脏。其中男6例,女4例,年龄27～69岁,平均(47.5±19.3)岁。肿瘤直径1.5～4.7 cm,平均(3.2±1.4)cm。其中腹侧7例,背侧3例,9例为单发肿瘤,1例为双侧肾肿瘤。术前按AJCC肾癌TNM肿瘤分期均为T₁N₀M₀。结果:10例均顺利完成LPN术。手术时间57～107 min,平均(87.2±20.4)min。术中失血量30～180 ml,平均(55.0±42.8)ml,肾动脉阻断(热缺血)时间11～32 min,平均(23.3±12.6)min。缝合时间8～21 min,平均(14.3±9.7)min。术后住院5～8 d,平均(6.5±1.3)d。无肾蒂血管损伤、继发性出血、尿漏等并发症,1例术后出现血尿,经保守治疗缓解。术后病理均为肾细胞癌,切缘均为阴性。随访1~6个月,无肿瘤局部复发和远处转移。缝合时间和热缺血时间明显短于普通缝线组,手术时间及继发性出血率均少于普通缝线组。结论:针对肾门部肾肿瘤,采用双向倒钩可吸收免打结线施行后腹腔镜肾部分切除术,能够明显缩短缝合时间和热缺血时间,有利于肾功能的保护,具有很好的安全性和可行性。

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	陈杰
	徐必友
	徐丹枫
	崔心刚
	高轶
	任吉忠
	姚亚成

关键词 ：双向倒钩免打结线, 后腹腔镜, 肾部分切除术, 肾肿瘤

Abstract：Objective:To evaluate safety and efficacy of the new bidirectional barbed free-knot absorbable suture (QUILL SRS) in laparoscopic partial nephrectomy of hilar tumors. Methods:The clinical data of 10cases of laparoscopic partial nephrectomy for renal hilar tumors were retrospectively analyzed. All cases were given QUILL SRS to suture the kidney. There were 6 males and 4 femaleswithage ranging from 27 to 69 years (mean [47.5±19.3] years). Tumor diameter was 1.5-4.7 cm (average [3.2±1.4] cm). There were 7 cases of ventral tumor and 3 cases of dorsal tumor. Nine cases suffered from single tumor and one from bilateral renal tumor. All patients were fallen into T₁N₀M₀ by AJCC TNM staging preoperatively. Results:LPN was successfully operated on 10 cases. Operation time was 57-107 min with an average of (87.2±20.4) min. Intraoperative blood loss was 30-180 mL with an average of (55.0±42.8) mL, renal artery occlusion (warm ischemia) time was 11-32 min with an average of (23.3±12.6) min. Suture time was 8-21 min with an average of (14.3±9.7) min. Postoperative hospital stay was 5-8 d with an average of (6.5±1.3) d. No renal pedicle vascular injury, secondary bleeding, urine leakage and other complications occurred. Postoperative bleeding and hematuria occurred in 1 case, and recovered after conservative treatment. Pathological findings were all Renal cell carcinoma was pathologically confirmed, and surgical margins were negative. After follow-up for 1-6 months, no local recurrence and distant metastasis occurred. Suture time and warm ischemia time were significantly shorter, the operation time was shorter, and secondary hemorrhage rate was less in LPN than in control group. Conclusions:Use of new bidirectional barbed free-knot suture in LPN for hilar tumors can significantly reduce the suture time and warm ischemia time, which is conducive to the protection of renal function with good safety and feasibility.

Key words： bidirectional barbed free-knot suture retroperitoneoscopy partial nephrectomy renal tumors

收稿日期: 2013-11-27

ZTFLH:

R737.11

通讯作者: 徐丹枫,xudfcz@hotmail.com

引用本文:

陈杰,徐必友,徐丹枫,崔心刚,高轶,任吉忠,姚亚成. 新型双向倒钩免打结缝合线在肾门部肿瘤腹腔镜下肾部分切除术中的应用[J]. 微创泌尿外科杂志, 2018, 7(s1): 6-.
Chen Jie,Xu Biyou,Xu Danfeng,Cui Xingang,Gao Yi,Ren Jizhong,Yao Yacheng. Applications of new bidirectional barbed free-knot suture in laparoscopic partial nephrectomy of hilar tumors. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(s1): 6-.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1388.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2018/V7/Is1/6

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