doi:10.3969/j.issn.1674-490X.2020.01.006

Abstract

Abstract: Objective To investigate the clinical efficacy and safety of laparoscopic nephron sparing surgery(LNSS)with the two different methods, main renal artery clamping(MRAC)and selective segmental renal artery clamping(SSRAC). Methods 84 patients, who had the localized renal tumor in stage T1, admitted from October 2017 to October 2018 were conducted a retrospective analysis,42 of the patients were operated with the method of SSRAC(Group S), and the other 42 patients were operated with the method of MRAC(Group M). The operative time, intraoperative blood loss, intraoperative warm ischemia time, postoperative hospital stay, positive margins, the values of serum creatinine rate(SCr)and blood urea nitrogen(BUN)before and after surgery, intraoperative and postoperative complications rate and so on were compared between the two surgical methods. Results All the operations were successfully completed, and there was no positive margins. There was no intraoperative transfer to MRAC in group S. There was no significant difference in the operation time and intraoperative blood loss between the Group S and the Group M(P<0.05). There was no significant difference in the duration of warm ischemia, postoperative drainage, and postoperative hospital stay(P>0.05). There was no significant difference in preoperative SCr and BUN levels between the two groups(P>0.05). The levels of SCr and BUN in the 1st day of postoperative period were significantly higher than those before surgery. There was significant difference in SCr and BUN between the 1st day after operations in the Group S(P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion SSRAC is a new renal artery occlusion technique. It is effective and safe in patients with LNSS, and its effect on renal function is small. This study still needs to be supported with large amounts of sample cases.

Key words: selective segmental renal artery clamping, main renal artery clamping, laparoscopic nephron sparing surgery, the localized renal tumor in stage T1, warm ischemia

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References

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