肾脏部分切除术术中血管处理方式的进展

Progress of Vascular Management in Partial Nephrectomy

外科手术治疗已经成为Ⅰ、Ⅱ期局限性肾癌的首选治疗方法,传统肾脏部分切除术需要对肾脏血管进行夹闭以减少术中出血确保手术的安全性。因此,热缺血时间及潜在的缺血再灌注损伤成为影响术后肾功能变化的关键因素。为了减少热缺血时间带来的肾功能丢失,近年来,肾脏部分切除术式中动脉的处理方式逐渐由阻断肾动脉向精确阻断肿瘤相关肾动脉分支血管及完全不阻断肾动脉肾脏部分切除手术发展。该文就肾脏部分切除术术中肾脏血管处理方式的进展做一综述。

Surgical treatment has become the preferred treatment for stageⅠandⅡlocalized renal cell carcinoma.Traditional partial nephrectomy requires clipping of the renal blood vessels to reduce intraoperative bleeding and ensure the safety of the operation.Therefore,warm ischemia time and potential ischemia-reperfusion injury have become the key factors that affect the changes in renal function after surgery.In order to reduce the loss of renal function caused by warm ischemia time,in recent years,the treatment of the arteries in partial nephrectomy has gradually developed from blocking the renal artery to precisely blocking the branch vessels of the tumor-related renal artery and completely unblocking the renal artery partial nephrectomy.This article reviews the progress of renal vascular management during partial nephrectomy.