腹腔镜胃切除术后急性肾衰竭两例及文献复习

Acute renal failure after laparoscopic gastrectomy:a report of 2 cases and literature review

目的通过分析腹腔镜胃切除术后急性肾衰竭的病例,探讨二氧化碳气体(CO2)气腹对腹腔镜胃癌根治术后肾功能的影响及预防措施。方法回顾分析2例腹腔镜胃癌根治术后出现急性肾衰竭患者的临床表现、辅助检查、临床治疗等,结合相关文献复习,对CO2气腹对腹腔镜胃癌根治术后肾功能的影响及预防措施进行相关讨论。结果患者经过连续肾脏替代治疗等处置,肾功能逐步好转。结论腹腔镜胃切除术后急性肾衰竭临床发生率低,治疗上经验不足,对于术前存在肾功能不全且合并高血压、糖尿病、冠心病等基础疾病的患者,应慎重选择腹腔镜手术治疗。

Objective To explore the effect and preventive measures of carbon dioxide pneumoperitoneum on renal function after laparoscopic radical gastrectomy for gastric cancer by analyzing the cases of acute renal failure after laparoscopic gastrectomy.Methods The clinical manifestations,auxiliary examinations and clinical treatments of 2 patients with acute renal failure after laparoscopic radical resection of gastric cancer were retrospectively analyzed,combined with the review of related literatures.The effects of carbon dioxide pneumoperitoneum on renal function and preventive measures after laparoscopic radical gastrectomy were discussed.Results After continuous renal replacement therapy,the renal function was gradually improved.Conclusions The clinical incidence of acute renal failure after laparoscopic gastrectomy is low and the treatment experience is rare.Laparoscopic surgery should be carefully selected for patients with renal insufficiency and complicated with basic diseases such as hypertension,diabetes,coronary heart disease and so on.