Observation of Effect of MSCTA and Intraoperative Ultrasound in Partial Nephrectomy with Retroperitoneal Laparoscopic Occlusion of Accessory Renal Artery
SONG Dianbin, et al
Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China
Abstract：Objective: To investigate the effect of preoperative multi-slice spiral CT angiography (MSCTA) and intraoperative ultrasound on laparoscopic obstruction of renal artery partial nephrectomy (LPN). Methods: According to whether MSCTA and intraoperative ultrasound were performed, 45 cases of small renal cell carcinoma from May 2014 to May 2017 in the Affiliated Hospital of Chengde Medical College were retrospectively reviewed. They were divided into two groups, 23 cases in the study group and 22 cases in the control group. Relevant data were compared between the two groups, including bleeding volume, operation time, intraoperative warm ischemia time, detection rate of microcarcinoma, conversion and opening rate, leakage of urine after operation, positive rate of incision margin, and determination of GFR in operation kidney. Results: The research group and the control group operation time was 115±5.0min and 132±4.8 min, respectively. The intraoperative blood loss was 80±3.0 ml and 108±3.8 ml, respectively. The mean time was 25±2.2 min and 32±2.6 min, respectively, The number of cases of open surgery was 1 and 3, respectively. and the difference was statistically significant (p<0.05). The number of cases of microscopic cancer lesions was 1 and 0, respectively. The number of cases of postoperative leakage was 0 and 1 respectively. The number of positive margins was 0 and 1 respectively. The preoperative and postoperative renal GFR of the research group were 57.1±7.2 ml/min and 56.1±7.7 ml/min (P>0.05), respectively. Renal GFR was 57.8±7.0 ml/min and 53.4±6.5 ml/min (P<0.05), respectively. Conclusion: MSCTA can detect the accessory renal artery provided by the tumor before operation, and guide the timely and accurate control during operation to reduce the amount of bleeding. At the same time, intraoperative ultrasound can quickly and accurately locate the tumor tissue, preserve the nephron as much as possible, and reduce the positive margin of the margin. And is conducive to the recovery of renal function after surgery.
宋殿宾, 毕海, 张晶晶, 马光, 李红阳, 刘英, 王志勇. 后腹腔镜阻断副肾动脉肾部分切除中应用MSCTA及术中超声的效果观察[J]. 河北医学, 2019, 25(9): 1549-1552.
SONG Dianbin, et al. Observation of Effect of MSCTA and Intraoperative Ultrasound in Partial Nephrectomy with Retroperitoneal Laparoscopic Occlusion of Accessory Renal Artery. HeBei Med, 2019, 25(9): 1549-1552.
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2019, Vol. 25 
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