铥激光在零缺血后腹腔镜肾脏小肿瘤切除术中的应用

The application of thulium laser in retroperitoneal laparoscopic nephron-sparing nephrectomy for renal tumor

目的探讨后腹腔镜铥激光零缺血行小体积肾肿瘤切除术的可行性、安全性及应用前景。方法分析总结本中心2例应用铥激光零缺血切除小体积肾肿瘤的诊疗经过、效果及5年随访资料,并进行相关文献复习。结果2例肾肿瘤患者均顺利通过铥激光零缺血完整切除肾肿瘤,术中无大出血,术后肾功能无显著下降,病理检查1例为透明细胞癌(Fuhrman 1级),1例为乳头状肾细胞癌(Ⅰ型),切缘均为阴性,5年随访未复发。结论后腹腔镜下铥激光肾肿瘤切除术在治疗小体积肾肿瘤中具有更好的肾功能保护优势及同等的肿瘤控制效果,是一种安全、可行且有良好应用前景的手术方式。

Objective Nephron-sparing nephrectomy has gradually become the preferred treatment for patients with small renal tumors. Controlling the warm ischemic time is vital for the protection of renal function. This article will discuss the feasibility, safety and prospect of retroperitoneal laparoscopic thulium laser zero ischemia partial nephrectomy for small renal tumors. Methods Two patients with small renal tumors treated by thulium laser zero ischemia resection were reported in our center, including the effects of surgeries and 5-year follow-up data, and then related literature was reviewed. Results Two cases of renal tumors were successfully resected by thulium laser without ischemia. There were no massive hemorrhage during operations and no significant decrease in renal function after operations. Pathological examination showed that one case was renal clear cell carcinoma (Fuhrman grade 1), and another was papillary renal cell carcinoma (type I). Both of cases showed negative margins, and there was no recurrence within 5 years. Conclusions Retroperitoneal laparoscopic thulium laser nephron-sparing nephrectomy is a safe, feasible and promising method for the treatment of small renal tumor.