改良铆钉缝合法在后腹腔镜下肾部分切除术中的应用

Application of Improved Rivet Suture in Retroperitoneal Laparoscopic Partial Nephrectomy

目的探讨改良铆钉缝合法在后腹腔镜下肾部分切除术中的临床效果。方法选取2019年3月至2022年3月因肾细胞癌于郑州人民医院泌尿外科接受后腹腔镜下肾部分切除术的患者,共81例,回顾其临床资料,根据缝合方法分为研究组(改良铆钉缝合,41例)和对照组(倒刺线连续缝合,40例),总结临床资料,比较两组患者的热缺血时间、术中出血量、术后引流量、术后尿漏发生率、术后肾周血肿发生率、术前术后血红蛋白下降情况。结果研究组热缺血时间短于对照组,术中出血量、术后引流量、术后尿漏及肾周血肿发生率均低于对照组(P<0.05)。术后研究组血红蛋白水平高于对照组,差异有统计学意义(P<0.05)。对照组中出现1例术后尿瘘和2例术后肾周血肿,经过治疗后好转,研究组未出现并发症。结论改良铆钉缝合法在后腹腔镜下肾部分切除术中效果确切,可缩短肾脏热缺血时间,减少术中出血量及术后并发症,值得在临床推广。

Objective To investigate the clinical effect of improved rivet suture in retroperitoneal laparoscopic partial nephrectomy.Methods A total of 81 patients undergoing retroperitoneal laparoscopic partial nephrectomy due to renal cell carcinoma in the Department of Urology of Zhengzhou People’s Hospital from March 2019 to March 2022 were selected.Clinical data was reviewed,according to different suture methods divided into the study group(improved rivet suture,41 cases)and the control group(continuous barb suture,40 cases).Clinical data were summarized,and the incidence of hot ischemia time,intraoperative blood loss,postoperative drainage volume,postoperative urinary leakage,postoperative perirenal hematoma,and preoperative and postoperative hemoglobin decline were compared between the two groups.Results The incidence of hot ischemia time in the study group was shorter than that in the control group,intraoperative blood loss,postoperative drainage volume,postoperative urinary leakage and perirenal hematoma in the study group were lower than those in the control group(P<0.05).The hemoglobin level in the study group was higher than that in thecontrol group after surgery(P<0.05).In the control group,there were 1 case of postoperative urinary fistula and 2 cases of postoperative perirenal hematoma,which improved after treatment,and no complications occurred in the study group.Conclusion The improved rivet suture in our hospital has a significant effect in postlaparoscopic partial nephrectomy,which can shorten the time of renal hot ischemia,reduce the amout of intraoperative blood loss and postoperative complications,and is worthy of clinical promotion.