“零缺血”技术在肾肿瘤保留肾单位手术中的研究进展

目的 总结“零缺血”技术在肾肿瘤保留肾单位手术中的研究进展。方法 以“肾肿瘤”“零缺血”“肾部分切除术”“保留肾单位手术”“栓塞”“激光”“水刀”“微波消融”“射频消融”和“renal cell carcinoma”“kidney neoplasms”“zero ischemia”“off-clamp partial nephrectomy”“ nephron sparing surgery”“embolization”“laser”“water jet”“microwave”“frequency ablation”为中、英文关键词,在中国知网、万方数据库、SinoMed、PubMed等中英文数据库中检索2002年1月—2018年8月间有关“零缺血”相关技术,以及其在肾肿瘤保留肾单位手术中应用的相关文献,检索到文献1 482篇,剔除内容不符合、无法获取全文、重复性研究或存在设计缺陷的文献,最终纳入42篇文献,对其进行总结、分析。结果 “零缺血”技术是基于对供应肾肿瘤的段动脉进行解剖分离并给予特异性阻断,或者在切除肿瘤时不阻断肾蒂血管的方法。在治疗肾肿瘤的同时,可最大限度地保护肾脏功能,在肾肿瘤的治疗中具有重要作用,可操作性强;但应关注该技术的相关并发症。结论 “零缺血”技术在肾肿瘤保留肾单位手术中具有重要作用,显示出了很好的应用前景;但其安全性、实用性仍需进一步研究探讨。

The research progress of zero ischemic technique in nephron-sparing surgery for kidney neoplasms

Objective To summarize the research progress of “zero ischemia” technique in nephron sparing surgery(NSS) for kidney neoplasms by reviewing literatures.Methods Using“renal cell carcinoma(RCC)” “kidney neoplasms” “zero ischemic” “off-clamp partial nephrectomy”“nephron sparing surgery(NSS)” “embolization” “laser” “water jet” “microwave” and “frequency ablation”as the key words to identify the articles about zero ischemia related technologies and applied in NSS in CNKI Data, WanFang Data, SinoMed and PubMed Data from January 2002 to August 2018. A total of 1 482 literatures were searched, and 42 literatures were finally included after excluding the literatures that did not conform to the content, could not obtain the full text, repeated studies or which had design defects.Results “Zero ischemia” is a method to block the specific artery supplying the renal tumor segments based on the anatomy, or to remove the tumor without clamping the renal pedicle vessels, which can extremely protect the renal function while curing the kidney neoplasms. It plays an important role in the treatment of the early kidney neoplasms due to the operability, but postoperative complications can not be ignored.Conclusions “Zero ischemia” technique shows brilliant application prospects in the treatment of the early kidney neoplasms, but the safety, practicability and clinical application value still need further discussion.