3种最短血流阻断技术在腔镜下肾肿瘤患者保留肾单位手术中的应用比较(“大家泌尿网”观看手术视频)

A comparative analysis of three minimal clamping techniques in patients with renal tumors undergoing laparoscopic nephron-sparing surgery

腹腔镜下肾部分切除术的优势在于对残肾功能的保护,在手术中减少热缺血相关肾实质损伤是临床上的难点问题。目前最短血流阻断技术被广泛应用,但此类方法可能增加术中出血的风险。为达到提高围手术期安全性和减少肾功能损伤的平衡,本中心对标准早期开放、“2+1”缝合法及早期序贯开放血流法3种技术进行了比较分析,并总结出合理运用上述方法的初步经验,本文就其手术步骤及适用条件做简要介绍。

The advantage of laparoscopic partial nephrectomy lies in the preservation of residual renal function.However,it remains difficult to reduce renal parenchymal injury associated with warm ischemia during operation.At present,minimal clamping techniques are widely used,but such methods may increase the risk of intraoperative bleeding.To achieve a balance between improving perioperative safety and reducing renal function damage,we conducted a comparative study on the standard early unclamping technique,“2+1”suture technique and early sequential unclamping method,and summarized the experience of application.In this paper,we will briefly introduce the surgical procedures and indications conditions of the three clamping techniques.