Recent clinical efficacy of laparoscopic partial nephrectomy without thermal ischemia for the treatment of T1a renal carcinoma

doi:10.3877/cma.j.issn.1674-3253.2020.03.008

Abstract

Abstract:

Objective

To investigate the clinical efficacy of laparoscopic partial nephrectomy (LPN) for the treatment of T1a renal carcinoma without renal pedicle occlusion.

Methods

The clinical data of stage T1a renal cell carcinoma from January 2016 to December 2018 in the First People's Hospital of Foshan were retrospectively analyzed. Twenty-four patients underwent laparoscopic partial nephrectomy without renal pedicle occlusion and the renal pedicle occlusion of 32 patients in the same period.

Results

Between no renal pedicle occlusion group and renal pedicle occlusion group, preoperative average creatinine (72 μmol/L vs 75 μmol/L), average operation time (64 min vs 60 min), postoperatively average creatinine (75 μmol/L vs 82 μmol/L) were not different significantly (P>0.05). Average intraoperative bleeding (100 ml vs 44 ml) and thermal ischemia time (0 min vs 25 min) were different significantly between two groups (P<0.05). Preoperatively ECT of surgical lateral kidney (51 ml/min vs 52 ml/min) was not different significantly between two groups, and the same between preoperative and preoperative (51 ml/min vs 49 ml/min) in no renal pedicle occlusion group (P>0.05). ECT of surgical lateral kidney was different significantly between preoperative and preoperative (52 ml/min vs 45 ml/min) in renal pedicle occlusion group (P<0.05). The postoperative pathological reports were all renal transparent cell carcinoma.All patients were followed up for 3-36 months with an average of 17 months, no recurrence and matastasis.

Conclusions

LPN for the treatment of T1a renal cell carcinoma could be performed safely with good outcomes. LPN is beneficial for the preservation of renal units and functions.

Key words: Kidney neoplasms, Laparoscopy, Thermal ischemia, Partial nephrectomyv

Taolin Xia, Jianhua Liu, Wenfeng Xu, Zhe Lin, Bin Li, Jiantang Lu, Zhenquan Wu, Huixin Li, Gouliang Hou, Weitao Liu. Recent clinical efficacy of laparoscopic partial nephrectomy without thermal ischemia for the treatment of T1a renal carcinoma[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(03): 192-195.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2020.03.008

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2020/V14/I03/192

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References 15

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组别		例数	年龄（岁，±s）	性别（例）		大小（cm，±s）	侧别（例）		位置（例）			血肌酐（μ mol/L，±s）	术侧ECT（ml /min，±s）
组别		例数	年龄（岁，±s）	男	女	大小（cm，±s）	左	右	上	中	下	血肌酐（μ mol/L，±s）	术侧ECT（ml /min，±s）
无肾蒂阻断组		24	48±7	15	9	2.7±1.2	13	11	12	2	10	72±9	51±5
肾蒂阻断组		32	49±6	19	13	2.8±1.3	15	17	15	7	10	75±9	52±5
	统计值	?	t=-0.46	0.06		t=-0.76	χ²=0.29		0.17			t=-0.91	t=-0.34
	P值	?	0.65	0.81		0.45	0.59		0.62			0.37	0.74

组别		例数	年龄（岁，±s）	性别（例）		大小（cm，±s）	侧别（例）		位置（例）			血肌酐（μ mol/L，±s）	术侧ECT（ml /min，±s）
组别		例数	年龄（岁，±s）	男	女	大小（cm，±s）	左	右	上	中	下	血肌酐（μ mol/L，±s）	术侧ECT（ml /min，±s）
无肾蒂阻断组		24	48±7	15	9	2.7±1.2	13	11	12	2	10	72±9	51±5
肾蒂阻断组		32	49±6	19	13	2.8±1.3	15	17	15	7	10	75±9	52±5
	统计值	?	t=-0.46	0.06		t=-0.76	χ²=0.29		0.17			t=-0.91	t=-0.34
	P值	?	0.65	0.81		0.45	0.59		0.62			0.37	0.74

组别		例数	手术时间（min）	热缺血时间（min）	术中出血量（ml）	术后1个月血肌酐（μmol/L，±s）	术后1个月GFR（ml/min，±s）
无肾蒂阻断组		24	64±13	0	100±25	75±90	49±5
肾蒂阻断组		32	60±12	25±7	044±10	82±10	45±4
	t值	?	1.5	-29.01	6.21	-1.27	2.55
	P值	?	0.14	<0.001	<0.001	0.06	0.01

组别		例数	手术时间（min）	热缺血时间（min）	术中出血量（ml）	术后1个月血肌酐（μmol/L，±s）	术后1个月GFR（ml/min，±s）
无肾蒂阻断组		24	64±13	0	100±25	75±90	49±5
肾蒂阻断组		32	60±12	25±7	044±10	82±10	45±4
	t值	?	1.5	-29.01	6.21	-1.27	2.55
	P值	?	0.14	<0.001	<0.001	0.06	0.01

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