Laparoscopic partial nephrectomy

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• 作者：Philip T. Zhao ; ^{philiptzhao@hotmail.com} ; Lee Richstone ; Louis R. Kavoussi
• 关键词：Laparoscopic partial nephrectomy ; Nephron-sparing surgery ; Kidney mass ; Kidney cancer ; Laparoscopy
• 刊名：International Journal of Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：36
• 期：part_PC
• 页码：548-553
• 全文大小：985 K
• 卷排序：36

文摘

Imaging of the renal mass (CT or MRI) must be present at time of surgery to confirm laterality and facilitate intraoperative decision-making. For obese patients, all trocar ports can be shifted laterally to help facilitate visualization and mobilization of the kidney. Intraoperative laparoscopic ultrasonography plays a key role in identifying margin and depth of tumor and is critical in resection of larger and more endophytic lesions. Off-clamp approach is ideally used for smaller and peripheral lesions while selective arterial clamping and VMD can be applied for more hilar and central tumors. There is no known safe threshold of warm ischemia time as each minute sequentially contributes to risk of developing acute kidney injury and long-term decline. Renal function following LPN is dependent on quality, quantity, and quickness – Rule of three Q's.