腹腔镜下选择性肾段动脉阻断肾部分切除术疗效评价

目的探讨腹腔镜下节段性肾动脉阻断肾部分切除术治疗肾肿瘤的方法及疗效。方法选取肾肿瘤患者11例,术前行CTA检查了解肾动脉情况。术中游离肾动脉主干、二级甚至三级肾动脉,选择性阻断肿瘤所在部位分级肾动脉,实施腹腔镜下肾部分切除术。结果 9例（81.8%）一次成功,2例转肾动脉主干阻断,手术时间70-200min,平均130min;术中出血量20-400ml,平均50ml。术后肾功能正常,本组无并发症。术后随访4-18个月,所有患者情况良好,复查CT等相关检查未见肿瘤复发或远处转移。结论临床分期T1a及T1b期、单发的肾肿瘤采用腹腔镜下节段性肾动脉阻断肾部分切除能有效地保护肾功能。

The clinical analysis of laparoscopic nephron-sparing surgery for renal tumor with renal segmental artery clamping

Objective To summarize the surgical technique and therapeutic effect of laparoscopic nephron-sparing surgery for renal tumor with renal segmental artery clamping. Methods Nephron sparing surgery was done for 11 cases.We checked the renal artery from CTA preoperatively.Separate the renal artery one by one,and block the branch of renal artery which supplies the tumor before nephron sparing surgery. Results 9 patients were technically successful.2 patients changed to clamp main renal artery during operation.The operative time was 70-200 min and the blood loss in the operation was 20-400 ml.No postoperative complication occurred.Neither local recurrence nor metastasis was observed during a follow up of 4-18 months. Conclusions Nephron sparing surgery is safe and effective for the treatment of renal neoplasms with renal segmental artery clamping.