肾脏错构瘤腹腔镜吸除技术与部分切除术疗效的对比研究
|
摘要
目的:探讨腹腔镜下肾脏零缺血免缝合肿瘤吸除技术治疗肾脏血管平滑肌脂肪瘤的优越性。方法:收集近期肾脏血管平滑肌脂肪瘤手术患者共21例,其中采用传统腹腔镜肾部分切除术患者14例(部分切除组),腹腔镜肿瘤吸除技术患者7例(吸除组),分析肿瘤吸除技术的临床优越性。利用SPSS 19.0统计学方法对其手术时间、术中出血量及术中有无输血等相应临床数据进行分析。结果:吸除组手术时间、术中出血量、术后绝对卧床时间、术后住院时间均少于部分切除组,差异有统计学意义(P<0.05)。结论:腹腔镜下肾脏零缺血免缝合肿瘤吸除技术治疗肾脏血管平滑肌脂肪瘤的效果显著,有助于术后恢复,安全性高,值得临床推广应用。
Objective:To explore the superiority of laparoscopic tumor aspiration technique with zero-ischemia and non-suture in the treatment of renal angiomyolipoma.Methods:A total of 21 cases of recently operated renal angiomyolipoma were collected,among which 14 cases were treated with traditional laparoscopic partial nephrectomy(partial nephrectomy group) and 7 cases were treated with laparoscopic tumor aspiration(aspiration group).SPSS 19.0 statistical method was used to analyze corresponding clinical data such as operation time,intraoperative blood loss and intraoperative blood transfusion or not.Results:Operation time,intraoperative blood loss,postoperative controlled bed rest time,time of postoperative stay of aspiration group were less than partial nephrectomy group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopic tumor aspiration technique with zero-ischemia and non-suture has significant effect on the treatment of renal angiomyolipoma,which is helpful to postoperative recovery and high safety.It is worthy of clinical popularization and application.
Objective:To explore the superiority of laparoscopic tumor aspiration technique with zero-ischemia and non-suture in the treatment of renal angiomyolipoma.Methods:A total of 21 cases of recently operated renal angiomyolipoma were collected,among which 14 cases were treated with traditional laparoscopic partial nephrectomy(partial nephrectomy group) and 7 cases were treated with laparoscopic tumor aspiration(aspiration group).SPSS 19.0 statistical method was used to analyze corresponding clinical data such as operation time,intraoperative blood loss and intraoperative blood transfusion or not.Results:Operation time,intraoperative blood loss,postoperative controlled bed rest time,time of postoperative stay of aspiration group were less than partial nephrectomy group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopic tumor aspiration technique with zero-ischemia and non-suture has significant effect on the treatment of renal angiomyolipoma,which is helpful to postoperative recovery and high safety.It is worthy of clinical popularization and application.
引文
[1] Liu HL,Wang SG,Hu ZQ,et al.The efficacy comparison between laparoscopic nephron-sparing surgery and robot-assisted laparoscopic nephron-sparing surgery in the treament of renal angiomyolipoma[J].Journal of Clinical Surgery,2018,26(5):382-384.[刘海浪,王少刚,胡志全,等.机器人辅助与普通腹腔镜治疗肾错构瘤的疗效比较[J].临床外科杂志,2018,26(5):382-384.]
[2] Murray TE,Doyle F,Lee M.Transarterial embolization of angiomyolipoma:A systematic review[J].J Urol,2015,194(3):635-639.
[3] Liu Y,Wang J,Ma SJ,et al.The treatment of renal hamartoma by retroperitoneal laparoscopic tumor enucleation:Report of 20 cases[J].J Clin Urol,2012,34(1):20-22.[刘雍,王军,马圣军,等.后腹腔镜肿瘤剜除术治疗肾错构瘤:附20例报告[J].临床泌尿外科杂志,2012,34(1):20-22.]
[4] Miual V,Aulakh BS,Daga G.Benign renal angiomyolipoma with in-fervor vena cava thrombosis[J].Urology,2011,77:1503-1506.
[5] Pang C,Pang L,Li CY,et al.Cryosurgery with argon helium knife guided by MRI navigation system for the treatment of 18 renal hamartoma[J].J Modern Urol,2014,19(11):743-745.[庞聪,庞蕾,李春艳,等.磁共振成像导航系统引导下氩氦刀冷冻介入治疗18例肾错构瘤[J].现代泌尿外科杂志,2014,19(11):743-745.]
[6] Kiefer RM,Stavropoulos SW.The role of interventional radiology techniques in the management of renal angiomyolipomas[J].Curr Urol Rep,2017,18(5):36.
[7] Liu J,Feng YG,Yu Z,et al.Diagnosis and treatment of 22 cases of renal hamartoma hemorrhage[J].Journal of Contemporary Urologic and Reproductive Oncology,2016,8(1):44-46.[刘军,奉友刚,余周,等.肾错构瘤破裂出血22例诊治分析[J].现代泌尿生殖肿瘤杂志,2016,8(1):44-46.]
[8] Minervini A,Siena G,Antonelli A,et al.Open versus laparoseopic partial nephrectomy for clinical T1a renal massesa:Matched-pair comparison of 280 patients with TRIFECTA outcomes(RECORd Project)[J].World J Urol,2014,32(1):257-263.
[9] Faddegon S,So A.Treatment of angiomyolipoma at a tertiary care centre:The decision between surgery and angioembolization[J].Can Urol Assoc J,2011,5(6):E138-E141.
[10] Thompson RH,Lane BR,Lohse CM,et al.Every minute counts when the renal hilum is clamped during partial nephrectomy[J].Eur Urol,2010,58(3):340-345.
[11] Sivalingam S,Nakada SY.Contemporary minimally invasive treatment options for renal angiomyolipomas[J].Curr Urol Rep,2013,14(2):147-153.
[12] Jeffrey Campbell,Garson Chan,Patrick P Luke.Early clamp release during laparoscopic partial nephrectomy:Implications for preservation of renal function[J].Can Urol Assoc J,2017,11(7):E261-E265.
[13] Wang JW,Chen YS,Yao YS,et al.Retroperitoneal laparoscopic partial nephrectomy for renal tumors[J].Int J Urol Nephrol,2018,38(4):544-547.[王家伟,陈弋生,姚友生,等.后腹腔镜下肾部分切除术治疗肾脏肿瘤[J].国际泌尿系统杂志,2018,38(4):544-547.]
[14] Wszolek MF,Kenney PA,Lee Y,et al.Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary kidney[J].BJU Int,2011,107(12):1886-1892.
[15] Li LP,Cao GS,Liu JW,et al.Effect observation on retroperitoneoscopic tumor enucleation combined with interventional embolization in the treatment of rupture hemorrhage of renal angiomyolipoma[J].International Medicine and Health Guidance News,2018,24(9):1361-1363.[李陆鹏,曹广劭,刘建文,等.后腹腔镜肿瘤剜除联合介入栓塞治疗肾错构瘤破裂出血的效果观察[J].国际医药卫生导报,2018,24(9):1361-1363.]
[2] Murray TE,Doyle F,Lee M.Transarterial embolization of angiomyolipoma:A systematic review[J].J Urol,2015,194(3):635-639.
[3] Liu Y,Wang J,Ma SJ,et al.The treatment of renal hamartoma by retroperitoneal laparoscopic tumor enucleation:Report of 20 cases[J].J Clin Urol,2012,34(1):20-22.[刘雍,王军,马圣军,等.后腹腔镜肿瘤剜除术治疗肾错构瘤:附20例报告[J].临床泌尿外科杂志,2012,34(1):20-22.]
[4] Miual V,Aulakh BS,Daga G.Benign renal angiomyolipoma with in-fervor vena cava thrombosis[J].Urology,2011,77:1503-1506.
[5] Pang C,Pang L,Li CY,et al.Cryosurgery with argon helium knife guided by MRI navigation system for the treatment of 18 renal hamartoma[J].J Modern Urol,2014,19(11):743-745.[庞聪,庞蕾,李春艳,等.磁共振成像导航系统引导下氩氦刀冷冻介入治疗18例肾错构瘤[J].现代泌尿外科杂志,2014,19(11):743-745.]
[6] Kiefer RM,Stavropoulos SW.The role of interventional radiology techniques in the management of renal angiomyolipomas[J].Curr Urol Rep,2017,18(5):36.
[7] Liu J,Feng YG,Yu Z,et al.Diagnosis and treatment of 22 cases of renal hamartoma hemorrhage[J].Journal of Contemporary Urologic and Reproductive Oncology,2016,8(1):44-46.[刘军,奉友刚,余周,等.肾错构瘤破裂出血22例诊治分析[J].现代泌尿生殖肿瘤杂志,2016,8(1):44-46.]
[8] Minervini A,Siena G,Antonelli A,et al.Open versus laparoseopic partial nephrectomy for clinical T1a renal massesa:Matched-pair comparison of 280 patients with TRIFECTA outcomes(RECORd Project)[J].World J Urol,2014,32(1):257-263.
[9] Faddegon S,So A.Treatment of angiomyolipoma at a tertiary care centre:The decision between surgery and angioembolization[J].Can Urol Assoc J,2011,5(6):E138-E141.
[10] Thompson RH,Lane BR,Lohse CM,et al.Every minute counts when the renal hilum is clamped during partial nephrectomy[J].Eur Urol,2010,58(3):340-345.
[11] Sivalingam S,Nakada SY.Contemporary minimally invasive treatment options for renal angiomyolipomas[J].Curr Urol Rep,2013,14(2):147-153.
[12] Jeffrey Campbell,Garson Chan,Patrick P Luke.Early clamp release during laparoscopic partial nephrectomy:Implications for preservation of renal function[J].Can Urol Assoc J,2017,11(7):E261-E265.
[13] Wang JW,Chen YS,Yao YS,et al.Retroperitoneal laparoscopic partial nephrectomy for renal tumors[J].Int J Urol Nephrol,2018,38(4):544-547.[王家伟,陈弋生,姚友生,等.后腹腔镜下肾部分切除术治疗肾脏肿瘤[J].国际泌尿系统杂志,2018,38(4):544-547.]
[14] Wszolek MF,Kenney PA,Lee Y,et al.Comparison of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary kidney[J].BJU Int,2011,107(12):1886-1892.
[15] Li LP,Cao GS,Liu JW,et al.Effect observation on retroperitoneoscopic tumor enucleation combined with interventional embolization in the treatment of rupture hemorrhage of renal angiomyolipoma[J].International Medicine and Health Guidance News,2018,24(9):1361-1363.[李陆鹏,曹广劭,刘建文,等.后腹腔镜肿瘤剜除联合介入栓塞治疗肾错构瘤破裂出血的效果观察[J].国际医药卫生导报,2018,24(9):1361-1363.]