The efficacy evaluation of partial nephrectomy with selective renal artery branch occlusion by laparoscopy

Abstract

Background: To investigate the clinical application and effect of laparoscopic partial nephrectomy with renal artery branch occlusion in the treatment of early renal tumors. Methods: A retrospective analysis was conducted on the clinical data of 15 cases of renal tumor patients who underwent partial nephrectomy by laparoscopic selective renal artery branch occlusion in our department from January 2017 to January 2018. Nine male patients and 6 female patients were aged 46 to 65 years, with an average age of 54.3 ± 7.2 years. The diameters of tumors were 2.2 to 4.0 cm, with an average of 3.3 ± 0.7 cm. There are 10 tumors locating on the left side and 5 on the right side. Preoperative renal glomerular filtration rate (GFR) were 77.3 to 61.9 mL/min with an average of 47.6 ± 7.5 mL/min. All patients’ diseased kidneys underwent renal computer tomography angiography examination before surgery. And the diseased kidney underwent reexamination of renal GFR. The operation time, renal artery branch occlusion time, intraoperative blood loss, postoperative hospital stay, changes of renal function, and complications were evaluated. Results: All surgery were completed successfully, the surgery time was 136.7 ± 15.2 min, intraoperative renal artery branch occlusion time was 21.3 ± 4.5 min, the intraoperative blood loss was 223.3 ± 69.5 mL, the postoperative hospital stay was 6.5 ± 1.7 days, and the postoperative 1-month GFR was 49.5 ± 6.6 mL/min. There was no significant difference between the renal GFR before and after surgery ( P > .05). There was no blood transfusion and transfer open surgery cases. The patients were followed up for 3 to 15 months without complications. Conclusions: Partial nephrectomy with selective renal artery branch occlusion by laparoscopy is a safe, feasible, and effective method for the treatment of early renal cancer. It makes good use of the technical advantages of clear operation field and fine operation of laparoscopic surgery, avoids the heat ischemia process of the whole kidney, and can better protect the renal function.

Recent Advances and New Perspectives in Surgery of Renal Cell Carcinoma

“…Since only the branch of renal artery in the tumor area is blocked, the requirement of blocking time will be relaxed, which can allow more time for tumor resection and suture. However, compared with the main renal artery occlusion, the operation time is longer, the wound caused by vascular separation is larger, and the intraoperative bleeding is more [13].…”

Uma Visão Geral Sobre as Complicações No Tratamento Pós-Operatório De Cancer Renal.

“…Wang et al (2021) teve como foco a avaliação da eficácia da nefrectomia parcial com oclusão seletiva de ramo da artéria renal por laparoscopia. Os resultados obtidos oferecem uma visão aprofundada sobre os desfechos clínicos dessa abordagem cirúrgica específica.…”