Clinical Nursing for Patients Undergoing Prone-Position Laparoscopic Partial Nephrectomy

Objective:To explore effective nursing strategies for patients undergoing prone-position laparoscopic partial nephrectomy.Methods:A total of 19 patients undergoing prone-position laparoscopic partial nephrectomy were selected,with hospital admission spanning from January 2024 to June 2024.Patients were randomly divided into the study group(n=10)and the control group(n=9).The control group received basic nursing care,while the study group received comprehensive high-quality nursing care.The recovery period,length of hospital stay,complication rates,SCL-90 scores,and nursing quality scores were compared between the two groups.Results:The recovery period and hospital stay were significantly shorter in the study group compared to the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).After the nursing intervention,the SCL-90 scores of the study group were lower than those of the control group(P<0.05).Nursing quality scores were higher in the study group than in the control group(P<0.05).Conclusion:Comprehensive high-quality nursing intervention for patients undergoing prone-position laparoscopic partial nephrectomy can shorten the recovery period and hospital stay,reduce the complication rate,improve mental health,and enhance nursing quality,making it suitable for wider application in medical institutions.

Solitary Fibrous Tumor of the Kidney Treated with Laparoscopic Partial Nephrectomy: A Case Report

We herein reported a 27-year-old woman with a right renal mass for two years.She underwent laparoscopic partial nephrectomy.Immunohistochemical examination of the specimen confirmed the diagnosis of solitary fibrous tumor by revealing its positive staining for cluster of differentiation(CD)34,epithelial membrane antigen(EMA),B-cell lymphoma-2(Bcl-2)and CD99 in the tumor cells.No adjuvant treatment was carried out.The patient was in good health without local recurrence or metastasis during 2 years of follow-up.Laparoscopic partial nephrectomy for renal solitary fibrous tumor is an alternative treatment to radical nephrectomy.It can provide a good outcome.However,further follow-up and more cases of renal solitary fibrous tumor treated with laparoscopic partial nephrectomy are necessary to compare the oncological outcome with radical nephrectomy.

Partial splenectomy using a laparoscopic bipolar radiofrequency device:A case report

We report a 51-year-old female patient with a solitary lymphangioma located in the upper splenic pole which was managed successfully with laparoscopic partial splenectomy.Surgery lasted 170 min and did not require blood transfusions.The patient recovered well post-operatively and was asymptomatic at the 3-mo follow-up.She had a normal platelet count and no recurrence on ultrasonography or computed tomography.Laparoscopic partial splenectomy is a safe,minimally invasive technique for the treatment of solitary splenic lymphangiomas in the splenic pole.We performed the procedure using the HabibTM 4X device.This laparoscopic bipolar radiofrequency device ensured a "bloodless" splenic parenchymal resection.

Laparoscopic Partial Splenectomy for Giant Hemangioma Misdiagnosed as Splenic Cyst:a Case Report

ALTHOUGH unusual, hemangioma is the most common type of primary splenic neoplasm.1 Usually, splenic hemangioma appears as solid mass, but sometimes it presents cystic corn-ponent as well, which is difficult to discriminate from some other lesions, such as abscess, simple cyst, parasitic cyst, and lymphangioma.2 Preoperative diagnosis of splenic hemangioma mainly depends on imaging study （e.g. ultrasonography, CT, MRI）.

Systematic review:Laparoscopic fundoplication for gastroesophageal reflux disease in partial responders to proton pump inhibitors

AIM: To assess laparoscopic fundoplication (LF) in partial responders to proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD).

Laparoscopic partial cystectomy with mucosal stripping of extraluminal duodenal duplication cysts

Duodenal duplication cysts are rare congenital anomalies.Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the duodenum.Here,we present an 8-year-old girl with a duodenal duplication cyst treated with partial cystectomy with mucosal stripping performed laparoscopically.Laparoscopic surgery can be considered as a treatment option for duodenal duplication cysts,especially in extraluminal locations.

Pneumothorax during retroperitoneal laparoscopic partial nephrectomy in a lupus nephritis patient:A case report

BACKGROUND Downgrading target treatment and laparoscopic partial nephrectomy have become increasingly popular in patients with renal cell carcinomas.Rare as it is,pneumothorax is one of the most severe intraoperative complications which needs immediate recognition.On the other hand,as a rheumatological disease,lupus nephritis requires a long period of hormone therapy.Cases of pneumothorax in hormone-consuming renal cancer patients are even fewer.CASE SUMMARY A 39-year-old woman was admitted to our department to take a laparoscopic partial nephrectomy.The patient had a medical history of lupus nephritis and renal clear cell carcinoma with hormone and target treatment.Her blood oxygen saturation dropped to 92%during the operation,and pneumothorax was detected by ultrasound.O2 inhalation and lung dilation were performed.Her vital signs were monitored closely throughout the operation.The operation was accomplished,and she regained consciousness smoothly.A postoperative bedside chest X-ray was conducted after she was transferred to the urosurgery ward,while no evidence of further pneumothorax or lib injury was observed.CONCLUSION Pneumothorax is a severe complication in laparoscopic or robotic-assisted laparoscopic operations,especially in retroperitoneal ones.It is easily neglected unless the injury of the diaphragm is found.Low insufflation pressure and shorter operation time are necessary for patients with a history of long-term hormone consumption or chronic immune system disease.

Prediction of Intraoperative Trifecta Achievement during Laparoscopic Partial Nephrectomy

Purpose: We introduce the concept of intraoperative Trifecta during laparoscopic partial nephrectomy (LPN) as the simultaneous achievement of estimated blood loss (EBL) < 500 ml, warm ischemia time (WIT) < 20 minutes and minimal changes of the intraoperative course. The study’s aim was to find preoperative factors that could predict the likelihood of achieving intraoperative Trifecta and build a surgical nomogram. Methods: We retrospectively evaluated 122 patients who underwent LPN. Preoperative factors like age, sex, body-mass index (BMI), kidney function, tumor characteristics (R.E.N.A.L. score) and Charlson-Comorbidity-Index (CCI) were recorded. Intraoperative complication (IOC) was graded according to the Rosenthal classification. R software was used to find a predicting model for achievement of Trifecta using preoperative variables and a nomogram was built. Results: The surgical features include median EBL of 100 ml having 6.5% bleed > 500 ml, median WIT of 12 minutes having 7.3% more than 20 minutes. There was recorded a 12.3% IOC with a mean Rosenthal’s grade of 0.2. Intraoperative Trifecta was achieved in 105 patients (86%) and three preoperative factors were chosen for the predictive model: BMI (p = 0.041), CCI (p = 0.037) and RENAL score (p = 0.002). A nomogram was generated and the ROC-AUC of the model was 75.8%. Conclusion: We have defined an intraoperative Trifecta concept as the achievement of EBL < 500 ml, WIT < 20 minutes and minimal changes of the intraoperative course. A nomogram was developed from preoperative factors like BMI, CCI and R.E.N.A.L. score. It can be used to estimate the probability of Trifecta achievement in patients treated with LPN.

Retroperitoneal laparoscopic partial nephrectomy for unilateral synchronous multifocal renal carcinoma with different pathological types:A case report

BACKGROUND The majority of renal cell carcinomas are single lesions;unilateral synchronous multifocal renal carcinoma(USMRC)is rarely reported and poses a treatment challenge for urological oncologists.CASE SUMMARY A 56-year-old man was hospitalized for pain and discomfort in the right kidney area for 6 d.Contrast-enhanced computed tomography demonstrated cT1a renal tumors at the lower pole of the right kidney and a cT1b renal tumor at the middle dorsal portion of the right kidney.The patient underwent retroperitoneal laparoscopic partial nephrectomy(RLPN).There were no complications peri-operatively.Histopathology revealed a low-grade,pathologic stage T1a(pT1a),clear cell renal cell carcinoma at the lower pole of the right kidney and a pT1b,chromophobe renal cell carcinoma at the middle dorsal portion of the right kidney.No tumor bed recurrence or metastasis was observed on imaging and his renal function remained stable during the 12-mo follow-up period.CONCLUSION RLPN is a safe,effective,and feasible for the management of USMRC,which can obtain equivalent oncological results with optimal renal function preservation.

Comparison of perioperative outcomes between laparoscopic and open partial splenectomy in children and adolescents

BACKGROUND In order to avoid consequences of total splenectomy,partial splenectomy(PS)is increasingly reported.The purpose of this study was to compare perioperative outcomes of laparoscopic PS(LPS)and open PS(OPS)in children and adolescents.AIM To compare perioperative outcomes of patients with LPS and OPS.METHODS After institutional review board approval,a total of 26 patients that underwent LPS or OPS between January 2008 and July 2018 were identified from the database of our tertiary referral center.In total,10 patients had LPS,and 16 patients underwent OPS.Blood loss was calculated by Mercuriali’s formula.Pain scores,analgesic requirements and complications were assessed.The Wilcoxon rank sum test was used for comparison.To compare categorical variables,Fisher’s exact test was applied.RESULTS LPS was performed in 10 patients;16 patients had OPS.Demographics(except for body mass index and duration of follow-up),indicating primary disease,preoperative spleen size and postoperative spleen volume,perioperative hematological parameters,postoperative pain scores,analgesic requirements,adverse events according to the Clavien-Dindo classification and the comprehensive complication index,median time from operation to initiation of feeds,median time from operation to full feeds,median time from operation to mobilization and median length of hospital stay did not differ between LPS and OPS.Median(range)operative time(min)was longer in LPS compared to the OPS group[185(135-298)vs 144(112-270),respectively;P=0.048].Calculated perioperative blood loss(mL of red blood cell count)was higher in the LPS group compared to OPS[87(-45-777)vs-37(-114-553),respectively;P=0.039].CONCLUSION This is the first study that compared outcomes of LPS and OPS.Both operative approaches had comparable perioperative outcomes.LPS appears to be a viable alternative to OPS.

Robotic-assisted laparoscopic partial nephrectomy: A comparison of approaches to the posterior renal mass

AIM: To evaluate outcomes of robotic-assisted laparoscopic partial nephrectomy performed for posterior renal tumors via a transperitoneal or retroperitoneal approach.METHODS: Retrospective review was performed for patients who underwent robotic-assisted laparoscopic partial nephrectomy(RALPN) for a posterior renal tumor between 2009-2015. Patient demographic characteristics, operative factors, pathology, oncologic outcomes, renal function, and tumor complexity were obtained. Radius of the tumor, exophytic/endophytic properties of the tumor, nearness of tumor to the collecting system, anterior/posterior position, location relative to the polar line(RENAL) nephrometry scores were calculated. nephrometry scores were calculated. The operative approach was determined by the primary surgeon. RESULTS: A total of 91 patients were identified who underwent RALPN for a posterior renal tumor. Fifty-four procedures were performed via the retroperitoneal(RP) approach, and 37 via the transperitoneal(TP) approach. There were no significant differences in patient factors(race, sex, age and body mass index), RENAL nephrometry scores, tumor size, conversion rates, or margin status. Among procedures performed on-clamp, therewas no significant difference in warm ischemia times. Total operative time(180.7 min for RP vs 227.8 min for TP, P < 0.001), robotic console time(126.9 min for RP vs 164.3 min for TP, P < 0.001), and median estimated blood loss(32.5 m L for RP vs 150 mL for TP, P < 0.001) were significantly lower via the RP approach. Off-clamp RALPN was performed for 31(57.4%) of RP procedures vs 9(24.3%) of TP procedures. Oncologic and renal functional outcomes were equivalent.CONCLUSION: The RP approach to RALPN for posterior renal tumors is superior with regard to operative time and blood loss and the ability to be performed off-clamp.

Single-site laparoscopic partial nephrectomy: Where are we going?

AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.

Surgical Video Review of Warm Ischemia Time during Laparoscopic Partial Nephrectomy and Impact on Positive Surgical Margins and Postoperative Complications

Introduction: A surgical video review is an emerging tool for quality improvement, especially in complex surgeries such as laparoscopic partial nephrectomy (LPN). Assessing and measuring the warm ischemia time (WIT) during LPN by dividing it into the time used for resection (ResT), time used for reconstruction (RecT) and intermediate time (IntT) has not been performed before. This study aimed to analyze the factors that can influence all these surgical times and assess their impact on positive surgical margins (PSM) and complication rates. Methods: We evaluated 36 surgical video recordings from patients who underwent LPN and measured WIT, ResT, RecT and IntT with a stopwatch. Factors such as tumor characteristics and surgeon experience were also recorded. SPSS software was used to identify the predictor factors for all these surgical times and to correlate the ResT with PSM and RecT with the complication rate. Results: We recorded a mean WIT of 887 seconds. The mean ResT, RecT and IntT were 240 (27.2% of WIT), 473 (52.6% of WIT) and 173 s (20.2% of WIT), respectively. We found a moderate correlation between the WIT (p = 0.030), IntT and the R.E.N.A.L. score (p = 0.019). The surgeon with less than 100 LPN had significantly longer WIT, ResT, and RecT values, with means of 977 (p = 0.015), 268 (p = 0.019) and 530 seconds (p = 0.015), respectively. No correlation was found between ResT and PSM (p = 0.418);however, a strong correlation was found between RecT and the probability of developing complications (p = 0.012). Conclusion: The surgeon’s experience influences WIT, ResT, and RecT, but not IntT, which depends on tumor complexity. RecT affects the probability of developing complications. IntT represents a fifth of the WIT and efforts to reduce the WIT should focus on reducing the IntT for complex tumors, by improving surgical planning.

Effects of laparoscopic normal hepatectomy and partial hepatectomy on inflammatory factors, stress hormones and immune function in patients with intrahepatic cholelithiasis

Objective:To investigate the effects of laparoscopic normal hepatectomy and partial open hepatectomy on inflammatory factors, stress hormones and immune function in patients with intrahepatic cholelithiasis.Methods: A total of 90 patients with intrahepatic cholelithiasis were randomly divided into control group and the observation group. The patients in the control group were treated with partial hepatectomy. Patients in observation group were treated with laparoscopic normal hepatectomy. The levels of inflammatory factors, stress hormones and immune function were compared in two groups before and after treatment.Results: Before treatment, there was no significant difference in the levels of neutrophile granulocyte, CRP, WBC, COR, E, CD3+, CD4+, CD8+ and NK cells between the two groups. After treatment, the levels of CD3+, CD4+ and NK cells in the observation group were significantly higher than those in the control group, moreover, these levels after treatment were obviously lower than before treatment;The levels of neutrophile granulocyte, CRP, WBC, COR, E and CD8+ in the observation group were significantly lower than those in the control group, and these levels were significantly higher than before treatment.Conclusion: Compared with partial open hepatectomy, laparoscopic normal hepatectomy can effectively reduce the inflammatory factors and stress hormone levels, improve the immune function of the body, and have a certain clinical value.

Harmonic scalpel versus traditional scissors in laparoscopic partial nephrectomy:A propensity score-based analysis

Objective:The present study aims to compare the clinical efficacy of laparoscopic partial nephrectomy using a harmonic scalpel versus traditional scissor.Methods:A retrospective review was conducted in patients with localized renal tumors and scheduled for laparoscopic partial nephrectomy from January 2015 to December 2019.Eventually,225 patients joined this retrospective study.Patients were divided into the harmonic scalpel group or scissor group based on the method used,with 71 cases and 154 cases respectively.Propensity score matching(1:1)was performed to adjust for potential baseline confounders,and each group had 57 cases.Patient characteristics,perioperative clinical results,complications,and oncological results were compared between the two groups.Results:After matching,patient characteristics were not significantly different between the two groups.The scissor group was associated with a significantly shorter operative time(105 min vs.130 min,p<0.001),shorter warm ischemia time(19.35 min vs.22.07 min,p?0.005).However,the harmonic scalpel group was associated with significantly less estimated blood loss(20 mL vs.30 mL,p?0.013)and shorter length of stay(8 d vs.10 d,p?0.040).There was no significantly difference in indwelling time of drainage tube,perioperative complication,oncological outcomes or recurrence rates.Conclusions:The harmonic scalpel is used safely and effectively in laparoscopic partial nephrectomy,and has benefits in intraoperative blood loss and length of stay.

Heminephrectomy for a large renal mass in a horseshoe kidney: A case report outlining a robotic assisted laparoscopic approach

With an incidence of 1/500,a horseshoe kidney is not uncommon.Tumours discovered in horseshoe kidney however are quite rare,and prove difficult to surgically manage due to complex vascular anatomy.With variable surgical approaches previously described,only a select few robot-assisted cases have been reported.This case describes one such robot-assisted laparoscopic heminephrectomy,with the use of indocyanine green and an endovascular stapler to successfully demarcate ischemia and achieve hemostasis intraoperatively.No complications were encountered,and pathology revealed a pT1bN0 clear cell renal cell carcinoma with negative surgical margins,demonstrating the feasibility of our approach.

Laparoscopic management of hydatid cysts using long ribbon gauze:An initial experience of 37 consecutive cases

Objective:The laparoscopic approach is becoming the standard of care for many surgical disorders.However,in the case of hydatid cysts,laparoscopic management is challenging due to the risk of spillage of hydatid fluid,which can cause an anaphylactic reaction and recurrence.Here,we report our initial experience with laparoscopic partial pericystectomy of hydatid cysts using long ribbon gauze to decrease intra-operative spillage.Method:This was a retrospective study(between January 2010 and December 2021)in the Department of Surgical Gastroenterology,Sanjay Gandhi Postgraduate Institute of Medical Science,a tertiary care referral center in northern India.Here,we have included 37 consecutive patients with hydatid cysts of the liver and spleen.Diagnosis was made by laboratory and imaging findings(abdominal sonography or contrast enhanced CT scans).All patients were managed with laparoscopic partial pericystectomy.Intraoperatively,a betadine-soaked long ribbon gauze,high-pressure suction canula,and an endo-bag were used in all patients.The collected data included patient demography,location,size,and number of cysts,WHO type,operative time,blood loss,postoperative complications,hospital stay and follow-up.Result:In our series,the mean age was 38.4±13.6 years,15(40.5%)were men and 22(59.5%)were women.The right lobe of the liver was the most commonly affected site(21,56.8%).The mean operative time was 80.0±32.0 min,and intraoperative blood loss was 23.6±11.5 mL.Bile leak was present in 6(16.2%)patients.There was no mortality.The hospital stay was 5(3,9)days,and no recurrence was observed at a median follow-up of 36 months.Conclusion:Laparoscopic partial pericystectomy using this technique is safe in the management of hydatid cysts.Simply,proper packing and safe removal of soaked gauzes can minimize the incidence of postoperative complications and recurrence.

Treatment of fat-poor renal angiomyolipoma with ectopic blood supply by fluorescent laparoscopy:A case report and review of literature

BACKGROUND Renal angiomyolipoma and renal cell carcinoma are the most common benign and malignant tumors of the kidney respectively,and the preoperative differential diagnosis is crucial due to the wide difference in treatment methods.Fat-poor renal angiomyolipoma is a relatively rare type of in renal angiomyolipoma.Its fat imaging features are not obvious,and it is easily misdiagnosed as renal cell carcinoma.CASE SUMMARY We report the case of a 41-year-old man who complained of osphyalgia.Subsequent abdominal computed tomography scans revealed that a heterogeneous mass was seen in the lower pole of the right kidney,with the size of about 53 mm×47 mm.And showed two right renal arteries,with the mass supplied by an ectopic vessel from the abdominal aorta.Fluorescent laparoscopic blockade of the right renal heterotopic artery and partial nephrectomy was performed.Based on histological and immunohistochemical findings,the tumor was diagnosed as fatpoor renal angiomyolipoma.CONCLUSION The use of fluorescent laparoscopy can effectively help intraoperative management,and the fluorescence pattern provided by intravenous indocyanine green can help suggest the final diagnosis,effectively guide the surgical decisionmaking,and avoid preoperative imaging diagnosis leading to nephrectomy for benign renal tumors,through fluorescent navigation of tumor supply vessel precise block,minimize the loss of renal function.

Robot-assisted laparoscopic partial nephrectomy: Contemporary results over a wide range of tumor complexity

Background Partial nephrectomy (PN) is considered the gold standard surgical treatment for renal masses < 7cm in size (T1 tumors). Since the introduction of the robotic-assisted laparoscopic PN (raPN) in high-volume centers, it has been increasingly adapted and standardized by urologists worldwide. There is growing evidence that the robot-assisted laparoscopic technique is associated with superior outcomes compared to those of open and conventional laparoscopic techniques. This study aimed to summarize the contemporary outcome data of raPN for renal tumors with varying degrees of complexity and to assess whether the outcomes reported from high-volume centers are reproducible in a limited caseload setting.Materials and methods This was a retrospective study of a single surgeon's experience, including 123 consecutive patients undergoing raPN at our institution. Ultimately, 110 patients were included in the analysis. Basic characteristics, tumor complexity as described by the RENAL score, complications described by the Clavien-Dindo classification system, and functional and oncological outcomes were assessed and analyzed statistically.Results Of the 110 patients, 27 (24%), 61 (55%), and 23 (21%) had low, intermediate, and high degrees of complexity, respectively, according to the RENAL score. A cancer-negative surgical margin was achieved in 108 (97%) patients. A total of 70 (64%) patients had no loss of renal function, while 20 (27%) had minimal loss of renal function. Complications of > 3 Clavien-Dindo classification during the first 30 postoperative days occurred in 5 (5%) patients. The 3 complexity groups were found to have significantly different ischemia time: Low, 8 minutes (interquartile range [IQR], 8–9.5);Intermediate, 12 minutes (IQR, 10–13);and High, 15.5 minutes (IQR, 11.25–18.75) (p < 0.001). There were no significant differences between the groups.Conclusions Contemporary standards for raPN are safe and reproducible. Adherence to the technique reported by centers of excellence yielded comparable results with regard to tumor control, preservation of renal function, and complication rates in lower-volume settings.

右美托咪定对腹腔镜肾部分切除术患者远期肾功能的保护作用

目的观察右美托咪定(DEX)对腹腔镜肾部分切除术(LPN)患者术后远期肾功能的保护作用。方法选取2021年5月至2022年12月安徽医科大学第二附属医院择期行LPN患者80例,根据随机对照表法将患者随机分为右美托咪定组和对照组,每组40例。右美托咪定组在肾动脉阻断前30 min给予DEX负荷量0.6 mg/kg,之后改为维持剂量0.5μg/(kg·h)并持续到手术结束前30 min。对照组静脉泵注相同剂量和时间的生理盐水。记录患者麻醉诱导前(T_(0))、插管即刻(T_(1))、肾动脉阻断即刻(T_(2))、肾动脉开放即刻(T_(3))和拔管即刻(T_(4))的平均动脉压(MAP)和心率(HR)。监测患者术前以及术后1、6个月^(99m)Tc-DTPA肾小球滤过率(GFR)、血清胱抑素C(Cys-C)和血清肌酐(SCr),并根据公式计算出基于SCr的估计GFR(eGFRcr)、基于SCr和Cys-C的估计GFR(eGFRcr-cys)和基于Cys-C的估计GFR(eGFRcys)。观察患者术前以及术后24 h和48 h血清中性粒细胞明胶酶相关载脂蛋白(NGAL)和尿肾损伤分子-1(KIM-1)含量。结果T_(1)、T_(4)时,右美托咪定组MAP低于对照组(P<0.05),T_(2)时,MAP高于对照组(P<0.05);T_(1)时,右美托咪定组HR低于对照组(P<0.05)。术后24 h和48 h,右美托咪定组血清NGAL和尿KIM-1低于对照组(P<0.05)。术后1、6个月,右美托咪定组手术侧^(99m)Tc-DTPA GFR值高于对照组(P<0.05),而两组对侧^(99m)Tc-DTPA GFR和总^(99m)Tc-DTPA GFR值比较,差异无统计学意义(P>0.05)。术后1、6个月,右美托咪定组eGFRcr-cys和eGFRcys值高于对照组(P<0.05),但两组eGFRcr值比较,差异无统计学意义(P>0.05)。结论DEX可对LPN术后远期肾功能产生保护作用,是防治LPN术后慢性肾脏病发生和发展的潜在治疗药物。