腹腔镜肾部分切除术中肾血管处理方法的研究进展

随着肾部分切除术的应用增加,影响腹腔镜保留肾单位手术术后患肾功能恢复的因素受到重视,术中热缺血时间是肾部分切除术后对患肾功能影响最大也是最可控制的影响因素。腹腔镜肾部分切除术中肾蒂血管的不同处理方式对术中热缺血时间及患肾功能有不同影响。目前国际上主要有3种对肾蒂血管的处理方式,即完全阻断肾蒂血管、阻断肾段动脉及不阻断肾血管的方法,它们分别有其应用的优势及局限性,术者应根据患者的具体情况、术者个人技术水平和经验以及具体的医疗条件制定详尽的手术方案。

Renovascular management in laparoscopic partial nephrectomy

Ischemia-reperfusion injury caused by vascular clamping contributes to the decline in glomerular filtration rate following laparoscopic partial nephrectomy (LPN). Warm ischemia time (WIT) is the most important and main modifiable factor that determines postoperative renal function. Nowadays LPN with or without clamping renal vessels or clamping segmental renal artery are the three main methods in dealing with renal vessels. They all have their own advantages and disadvantages on WIT and renal function. Surgery should design a detailed operation plan according to the patients' condition, surgeries' surgical skills and the local medical levels.