Abstract：Objective: To estimate the feasibility, efficiency, safety of a new surgical technique used in the partial nephrectomy for the renal hilar tumors localizing at renal lips. Methods: 18 patients with renal hilar tumors at renal lips underwent partial nephrectomy using a new surgical technique between June 2013 and November 2014. The operative time, intraoperative blood loss, time of warm ischemia, perioperative serious complications, positive margin status of the tumor specimens, hospital staying days, renal function on affected kidney of 3-12 months follow-up and status of recurrence were recorded and analyzed. Results: No surgeries were converted to open method. The mean operative time was 150 minutes. The mean warm ischemia was 25 minutes. One repair for the defect at renal vein was performed. The severe perioperative complications such as serious blood loss and urine leakage were not recorded. Thehistopathology confirmed 15 of renal cell carcinoma with negative margin and 3 renal angiomyolipoma. The mean hospital staying days were 8 days. No radiologicalrecurrence was found in the 3-12 months period of follow-up. The increase of the GFR on affected kidney was less than 8 mL/min. Conclusions: Our new surgical technique used in the partial nephrectomy for the renal hilar tumors localizing at renal lips was feasible, efficient, and safe.
俞鸿凯,马鑫,李宏召,杜青山,张旭. 一种新的肾门前后唇巨大肾门肿瘤的肾部分切除术外科技术及其局部解剖学原理(附18例报告)[J]. 微创泌尿外科杂志, 2015, 4(3): 163-166.
Yu Hongkai, Ma Xin, Li Hongzhao, Du Qingshan, Zhang Xu. A new surgical technique used in the partial nephrectomy for the renal hilar tumors localizing at renal lips and its anatomical principle. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(3): 163-166.
[1]Lattouf JB, Beri A, D'Ambros OF, et al. Laparoscopic partial nephrectomy for hilar tumors: technique and results. Eur Urol, 2008,54(2):409-416. [2]Rogers CG, Singh A, Blatt AM, et al. Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol, 2008,53(3):514-521. [3]Gong Y, Du C, Josephson DY, et al. Four-arm robotic partial nephrectomy for complex renal cell carcinoma. World J Urol, 2010,28(1):111-115. [4]Porpiglia F, Volpe A, Billia M, et al. Assessment of risk factors for complications of laparoscopic partial nephrectomy. Eur Urol ,2008,53(3):590-596. [5]Gill IS, Colombo JR Jr, Frank I, et al. Laparoscopic partial nephrectomy for hilar tumors. J Urol, 2005,174(3):850-854. [6]Dulabon LM, Kaouk JH, Haber GP, et al. Multi-institutional analysis of robotic partial nephrectomy for hilar versus nonhilar lesions in 446 consecutive cases. Eur Urol, 2011,59(3):325-330. [7]Petros FG, Rogers CG. Computer-assisted robotic renal surgery. Ther Adv Urol, 2010,2(3):127-132. [8]Bernhard JC, Ferrière JM, Crepel M, et al. 973 oncological results of nephron sparing surgery for hilar tumours. Eur Urol Suppl, 2007,6(2):266. [9]Novick AC. Nephron-sparing surgery for renal cell carcinoma. Annu Rev Med, 2002,53:393-407. [10]Mabjeesh NJ, Avidor Y, Matzkin H. Emerging nephron sparing treatments for kidney tumors: a continuum of modalities from energy ablation to laparoscopic partial nephrectomy. J Urol, 2004,171(2 Pt 1):553-560. [11]Bernardo NO, Gill IS. Laparoscopic partial nephrectomy: current status. Arch Esp Urol, 2002,55(7):868-880. [12]Finelli A, Gill IS. Laparoscopic partial nephrectomy: contemporary technique and results. Urol Oncol, 2004,22(2):139-144. [13]Waldert M, Waalkes S, Klatte T, et al. External validation of the preoperative anatomical classification for prediction of complications related to nephron-sparing surgery. World J Urol, 2010,28(4):531-535. [14]Gil-Vernet J. New surgical concepts in removing renal calculi. Urol Int, 1965,20(5):255-288. [15]Hillyer S, Spana G, White MA, et al. Novel robotic renorrhaphy technique for hilar tumours: 'V' hilar suture (VHS). BJU Int, 2012,109(10):1572-1577.
