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| 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 |
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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.
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[1] 陈威,肖龙明,杨巧智,等.肾段动脉阻断与肾动脉全阻断在后腹腔镜肾部分切除术中的应用比较[J].基层医学论坛,2018,22(7):935~936.
[2] 罗东,张应和,覃智颖,等.多排螺旋CT对副肾动脉发生及影响因素的评价研究[J].功能与分子医学影像学(电子版),2016,5(4):23~26.
[3] 鲍光进,李树平,洪骥,等.320排动态容积CT检测肾动脉解剖形态在介入治疗中的应用价值[J].介入放射学杂志,2016,25(1):24~28.
[4] 孙爱军.后腹腔镜下根治性肾切除术的疗效及安全性分析[J].中国药物经济学,2017,12(1):97~99.
[5] 曹嘉正,余新立,廖勇彬,等.高选择性肾动脉分支阻断术在腹腔镜肾部分切除术中的应用[J].中华腔镜泌尿外科杂志(电子版),2017,11(3):46~49.
[6] 张立平,邢建华.副肾动脉影像学检查的应用进展[J].临床超声医学杂志,2018,20(3):188~190.
[7] 杨寅.MSCT扫描与CTA技术对肾脏和肾血管疾病的诊断价值分析[J].解放军预防医学杂,2017,36(6):636~638.
[8] Tabayoyong W, Abouassaly R, Kiechle J E, et al. Variation in surgical margin status by surgical approach among patients undergoing partial nephrectomy for small renal masses[J]. The Journal of urology, 2015, 194(6): 1548~1553.
[9] 邱敏,向军吉,马潞林,等.实时超声监测后腹腔镜下肾部分切除术治疗完全内生型肾肿瘤的疗效分析[J].中华泌尿外科杂志,2016,37(10):730~734. |
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2019, Vol. 25 
