[1]彭伟力,刘涵博,邱佳美,等.超选择性肾动脉栓塞辅助T1期肾癌肾部分切除的临床研究 [J].介入放射学杂志,2024,33(11):1192-1196.
 PENG Weili,LIU Hanbo,QIU Jiamei,et al.Super selective renal artery embolization-assisted partial nephrectomy for T1 stage renal carcinoma:a clinical study[J].journal interventional radiology,2024,33(11):1192-1196.
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超选择性肾动脉栓塞辅助T1期肾癌肾部分切除的临床研究
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年11
页码:
1192-1196
栏目:
肿瘤介入
出版日期:
2024-11-20

文章信息/Info

Title:
Super selective renal artery embolization-assisted partial nephrectomy for T1 stage renal carcinoma:a clinical study
作者:
彭伟力刘涵博邱佳美张佳琪夏燕刘阳刘锋沃奇军张大宏陈骏
Author(s):
PENG WeiliLIU HanboQIU JiameiZHANG JiaqiXIA YanLIU YangLIU FengWO QijunZHANG DahongCHEN Jun.
Department of Interventional Medicine,Zhejiang Provincial People′s Hospital (Affiliated People′s Hospital of Hangzhou Medical College),Hangzhou,Zhejiang Province 310014,China
关键词:
【关键词】超选择性肾动脉栓塞肾部分切除术热缺血时间肾癌
文献标志码:
A
摘要:
【摘要】目的探讨超选择性肾动脉栓塞(SRAE)辅助腹腔镜下肾部分切除术(LPN)的临床应用价值。方法回顾性分析T1期肾癌患者LPN的临床资料,分为不阻断肾门行LPN的超选择性肾动脉栓塞(SRAE)组和阻断肾门行LPN的肾门血管阻断(VC)组,比较两组手术时间、术中出血量及术前术后肾功能等情况。根据热缺血时间(WIT)不同将VC组分为WIT<25 min和WIT≥25 min两个亚组并比较术前术后肾功能情况。结果59例患者入组,其中SRAE组12例,VC组47例。VC组中,WIT<25 min的33例,WIT≥25 min的14例。SRAE组和VC组中无中转行开放手术的病例,也无中转行肾全切的病例。SRAE组无中转行常规LPN手术的病例。SRAE组与VC组手术时间相比差异无统计学意义[100.50(73.75,132.50) min vs 120.00(90.00,145.00) min,P>0.05]。SRAE组的术后肾小球滤过率高于VC组[100.56(82.85,106.81) mL/min×1.73 m2 vs 84.66(70.84,94.85) mL/min×1.73 m2,P<0.05]。VC组的术后血清肌酐高于SRAE组[72.24(65.97,80.27) μmoL/L vs 90.50(77.10,104.90) μmoL/L,P<0.05]。SRAE组的术中出血量低于VC组[50(50,50) mL vs 50(50,100) mL,P<0.05]。VC组中WIT≥25 min亚组患者术后肾小球滤过率低于WIT<25 min亚组患者[66.13(47.08,82.50) vs 90.80(77.18,98.78),P<0.05]。SRAE组和VC组患者术后1年随访复查都未发现复发病例。结论SRAE辅助LPN较常规LPN术中无需阻断肾门,避免了缺血潜在的残肾功能受损,且可以减少术中出血量,不增加手术时间,不增加术后出血等并发症,不影响疗效和预后。

参考文献/References:

[1]Sung H,Ferlay J,Siegel RL,et al.Global Cancer Statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71:209-249.
[2]陈家财,曾宾华,李金雨,等.腹腔镜下肾动脉阻断肾部分切除术治疗cT1期肾癌的疗效及对肾功能的影响[J].临床外科杂志,2022,30:121-124.
[3]王华超,叶鹏,黄焱等.超选择性肾动脉栓塞联合经腹腹腔镜肾部分切除术在老年T1b期肾癌中的应用[J].现代肿瘤医学,2019,23:4210-4213.
[4]Mir MC,Derweesh I,Porpiglia F,et al.Partial nephrectomy versus radical nephrectomy for clinical T1b and T2 renal tumors:a systematic review and meta-analysis of comparative studies[J].Eur Urol,2017,71:606-617.
[5]Gill IS,Aron M,Gervais DA,et al.Clinical practice. Small renal mass[J].N Engl J Med,2010,362:624-634.
[6]Antonelli AD,Cindolo L,Sandri M,et al. The role of warm ischemia time on functional outcomes after robotic partial nephrectomy:a radionuclide renal scan study from the clock randomized trial[J].World J Urol,2023,41:1337-1344.
[7]卢灿峰,刘刚,窦中岭.后腹腔镜肾部分切除术中热缺血时间对肾肿瘤患者肾功能及并发症的影响[J].癌症进展,2021,19:2440-2442,2460.
[8]Thompson RH,Lane BR,Lohse CM,et al.Every minute counts when the renal hilum is clamped during partial nephrectomy[J].Eur Urol,2010,58:340-345.
[9]尚鸣异,王国良,韩宏杰,等. 无水乙醇术前肾动脉栓塞治疗肾癌的临床疗效分析[J].介入放射学杂志,2010,19:399-401.
[10]Salsano G,Palermo B,Barattini M,et al.Pre-operative renal artery embolization in laparoscopic radical and partial nephrectomy:a multidisciplinary approach to renal tumors[J].Surg Technol Int,2020,36:23-28.
[11]Shanmugasundaram S,Cieslak JA,Sare A,et al.Preoperative embolization of renal cell carcinoma priorto partial nephrectomy:a systematic review and meta-analysis[J].Clin Imaging,2021,76:205-212.doi:10.1016/j.clinimag.2021.04.021.
[12]陈欣然,高宇,彭程,等.术前肾动脉栓塞在复杂性右侧肾癌合并下腔静脉瘤栓治疗中的作用[J].微创泌尿外科杂志,2021,10:289-293.


备注/Memo

备注/Memo:
(收稿日期:2023-11-10)
(本文编辑:茹实)
更新日期/Last Update: 2024-11-20