肾门肿瘤的腹腔镜手术难点和技巧改进

Difficulty and technique improvement of laparoscopic surgery for renal sinus tumor

腹腔镜肾部分切术(LPN)已成熟应用于治疗早期局限性肾癌,但在复杂性肾肿瘤中仍存在局限性。自2005年报道成功在肾门部肾肿瘤实施LPN以来,随着手术技术的改进,肾门部肿瘤的保肾手术成功率不断提高。我们中心自2015年起通过结合术前IQQA智能三维及3D成像、术前评分、术中缝合技术、肾动脉阻断技术等多种技术及方法,显著提高了手术安全性和可行性。本文针对肾门部肾肿瘤LPN的术前评估规划、术中技巧、难点改进等方面做简要综述。

Laparoscopic partial nephrectomy(LPN) has matured in the treatment of early localized renal carcinoma, but it still has limitations in complex renal tumors. Since the successful implementation of LPN in hilar renal tumors was reported in 2005, with the improvement of surgical techniques, the success rate of kidney-preserving surgery for hilar renal tumors has been increasing continuously. Since 2015, our center has significantly improved the safety and feasibility of surgery by combining various technologies and methods such as preoperative IQQA intelligent 3 D and 3 D imaging, preoperative scoring, intraoperative suture technology, renal artery occlusion technology and so on. In this paper, preoperative evaluation planning, intraoperative techniques and improvement of difficulties in hilar renal tumor LPN were briefly reviewed.