后腹腔镜保留肾单位手术治疗副肾动脉供血的肾肿瘤

目的：探讨后腹腔镜保留肾单位手术中使用三套管自制套索法控制副肾动脉供血的手术方法和临床效果。方法：采用后腹腔镜技术对5例副肾动脉供血的肾肿瘤患者行肾部分切除术。男4例，女1例，年龄22～60岁，平均45岁。其中肾透明细胞癌3例，肾错构瘤2例。肿瘤大小2．2～7．0cm，平均3．2cm。结果：5例手术均获得成功。手术时间120～180min，平均150min。副肾动脉阻断时间18～38min，平均22min。术中出血量50～100ml，平均70ml。平均术后住院时间8天，无围手术期并发症。病理检查3例肾透明细胞癌切缘阴性，随访4～28个月未见复发。结论：后腹腔镜肾部分切除术安全可行，在其中采用三套管自制套索法控制副肾动脉供血具有操作简便、干扰少等优点，值得进一步推广应用。

Retroperitoneal Laparoscopic Nephron-Sparing Surgery for Renal Tumor Supplied Blood by Accessory Renal Artery

Objective：To evaluate the feasibility and clinical efficacy of using homemade lasso to control the accessory renal artery in retroperitoneal laparoscopic nephron-sparing surgeny for the treatment of renal tumor. Methods：2 patients with benign renal tumor and 3 with malignant renal tumor underwent enucleation and wedge resection of the renal tumor supplied blood by accessory renal artery through retroperitoneal laparoscopic. Of the 5 patients ,4 were men and 1 was women. Their mean age was 45 years （from 22--60 years old）. The mean tumor size was 3.2 cm in diameter. Results： All the procedures were technically successful without conversion to open surgery in the 5 patients. The mean operative time was 150 rain （ from 120 180 min） and mean blood lost was 70 ml （ from 50-- 100 ml）, The mean postoperative hospital stay was 8 days. No intraoperative or postoperative complication occurred. All 3 cases of malignant renal tumor had negative surgical margins for cancer . With a follow-up of 4--28 months, no recurrence was found. Conclusions：Retroperitoneal laparoscopic partial nephrectomy is feasible and safe for seleetive patients with renal tumors. Using homemade lasso to control the accessory renal artery in retroperitoneal laparoscopie partial nephrectomy is simple and less interferential.