Pre-operation MSCTA combined with intraoperative ultrasound for application of laparoscopic kidney-preserving surgery for treatment of small renal cancer
10.13929/j.issn.1672-8475.2020.07.009
- VernacularTitle: 术前MSCTA联合术中超声辅助腹腔镜保肾手术治疗小肾癌
- Author:
Dianbin SONG
1
Author Information
1. Department of Urology, The Affiliated Hospital of Chengde Medical University
- Publication Type:Journal Article
- Keywords:
Angiography;
Kidney neoplasms;
Kidney-preserving surgery;
Laparoscopy;
Tomography, X-ray computer;
Ultrasound examination
- From:
Chinese Journal of Interventional Imaging and Therapy
2020;17(7):421-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To observe the value of preoperative multi-slice spiral CT angiography (MSCTA) and intraoperative assisted ultrasound in application of laparoscopic kidney-preserving surgery for treating small renal cancer (tumor diameter ≤4 cm). Methods: A total of 85 patients with small kidney cancer underwent retroperitoneal laparoscopic nephron-sparing surgery, including 43 underwent preoperative MSCTA and intraoperative assisted ultrasound (observe group) and 42 underwent preoperative routine renal ultrasound and CT examination (control group). The relevant indicators were compared between the two groups. Results: Preoperative MSCTA findings of observe group were consistent with intraoperative findings. The operative time, intraoperative heat ischemia time, intraoperative blood loss and postoperative hospital stay in observe group were all less than those in control group (all P<0.05). In observe group, microcarcinoma was found in 1 case with ultrasound during operation, no positive resection margin nor urine leakage occurred after operation. In control group, postoperative urine leakage occurred in 2 patients (cured after conservative treatment with D-J tube implantation) and positive resection margin in 2 patients (recurred in the follow-up, 1 underwent retroperitoneal laparoscopic radical nephrectomy, and 1 underwent nephron sparing open surgery). There was no statistical difference of preoperative nor postoperative levels of serum creatinine, urea nitrogen and glomerular filtration rate (GFR) of affected kidney between the two groups (all P>0.05), while the postoperative GFR of control group was lower than that before surgery (P=0.040). Conclusion: Preoperative MSCTA and intraoperative auxiliary ultrasound during retroperitoneal laparoscopic nephron-sparing surgery for patients with small renal carcinoma can reduce intraoperative blood loss and positive rate of resection margin, reserve as much nephrons as possible to promote the recovery of renal function.
