摘要目的: 探讨氰基丙烯酸正丁酯为主要成分的外科止血胶在后腹腔镜下肾部分切除术（RLPN）中的安全可行性及优势。方法: 回顾性分析2020年9月至2021年3月新疆医科大学第一附属医院泌尿外科行RLPN患者97例,其中后腹腔镜下标准缝合止血组50例（标准缝合组）,单独使用氰基丙烯酸正丁酯止血胶或辅助单极电刀“点对点”式电凝止血组47例（免缝合组),比较两组患者围手术期指标及随访结果。结果: 两组患者年龄、基础疾病、肿瘤病理类型、肿瘤最大直径、基底缝合、肿瘤深度及R.E.N.A.L评分差异均无统计学意义（P>0.05）。免缝合组相比标准缝合组手术时间[（66.28±27.98） vs. （106.62±51.53）min]、阻断时间[（13.83±5.92） vs. （20.26±5.72）min]、术后住院时间[（4.47±0.93） vs. （5.18±1.30）d]、术后拔管时间短[（4.30±0.66） vs. （4.78±1.14）d],术中出血量[（47.45±27.62） vs. （179.31±114.24）ml]、eGFR下降率低[（2.41±8.99）% vs. （13.15±10.53）%],差异具有统计学意义（P<0.05）。结论: 氰基丙烯酸正丁酯止血胶免缝合技术在RLPN手术治疗T1期肾肿瘤中的安全性与标准缝合治疗一致,可在临床推广应用。
Abstract：Objective: To investigate the safety, feasibility and advantages of surgical hemostatic glue with n-butyl cyanoacrylate as main component in retroperitoneal laparoscopic partial nephrectomy （RLPN）. Methods: From September 2020 to March 2021, 97 patients who underwent RLPN in the Department of Urology of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed, including 50 patients in the standard suture group （standard suture group） under retroperitoneal laparoscopy and 47 patients in the point-to-point electrocoagulation group （no-suture group）, and the perioperative indexes and follow-up results of the two groups were compared. Results: There was no significant difference in age, underlying disease, tumor pathological type, tumor maximum diameter, basal suture, tumor depth and R.E.N.A.L score between the two groups （P>0.05）. The suture-free combination group had shorter operative time [（66.28±27.98） vs. （106.62±51.53） min], blocking time [（13.83±5.92） vs. （20.26±5.72） min], postoperative hospital stay [（4.47±0.93） vs. （5.18±1.30） d], and postoperative extubation time [（4.30±0.66） vs. （4.78±1.14） d] than in the no-suture group. In the suture-free combination group and no-suture group, intraoperative blood loss [（47.45±27.62） vs. （179.31±114.24） mL] and eGFR decline rate were low [（2.41±8.99）%vs（13.15±10.53）%], and the difference was statistically significant between two groups （P<0.05）. Conclusion: The safety of n-butyl cyanoacrylate hemostatic glue-free suture technique in RLPN surgery for T1 renal tumors is consistent with standard suture therapy, and can be widely applied in clinical practice.
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