Volume 21 Issue 9
Sep.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(9): 1461-1465
WANG Jinhang, GUO Yuanyuan, SUN Wei, GAO Wuyue, LIU Jianmin, LIU Beibei. Effect analysis of laparoscopic partial nephrectomy combined with modified renal artery perfusion in the treatment of complex renal tumors[J]. Chinese Journal of General Practice, 2023, 21(9): 1461-1465. doi: 10.16766/j.cnki.issn.1674-4152.003146
Citation: WANG Jinhang, GUO Yuanyuan, SUN Wei, GAO Wuyue, LIU Jianmin, LIU Beibei. Effect analysis of laparoscopic partial nephrectomy combined with modified renal artery perfusion in the treatment of complex renal tumors[J]. Chinese Journal of General Practice, 2023, 21(9): 1461-1465. doi: 10.16766/j.cnki.issn.1674-4152.003146
shu

Effect analysis of laparoscopic partial nephrectomy combined with modified renal artery perfusion in the treatment of complex renal tumors

doi: 10.16766/j.cnki.issn.1674-4152.003146

  • Department of Urology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 KJ2017A244

 Byycxz22067

 2022094

  • Received Date: 2023-03-03
    Available Online: 2023-10-19
    Abstract
  •   Objective  To evaluate the safety, feasibility and short-term efficacy of laparoscopic partial nephrectomy (LPN) combined with modified renal artery perfusion in the treatment of complex renal tumors.  Methods  Fifty patients with complex renal tumors treated with LPN in the Department of Urology of the First Affiliated Hospital of Bengbu Medical College from October 2021 to October 2022 were selected, in which LPN combined with modified renal artery cryogenic perfusion was used as the study group (20 cases), and not combined with modified renal artery cryogenic perfusion was used as the control group (30 cases). Operation related indexes, renal function indexes and complications were compared between the two groups. H&E staining were performed on the slices of normal kidney tissues adjacent to the tumor to observe the changes of ischemia and hypoxia under the microscope.  Results  Compared with the control group, the decrease of total GFR and GFR on the affected side of renal function index in the study group after operation were lower [(8.81±2.50) mL/min vs. (14.48±2.90) mL/min, (9.37±2.50) mL/min vs. (14.38±1.80) mL/min, P < 0.01]. The intraoperative renal temperature and blood loss in the study group were significantly lower than those in the control group [(21.18±2.34) ℃ vs. (32.48±1.13) ℃, (105.00±30.17) mL vs. (141.30 ±57.00) mL, all P < 0.05]. Pathological score of microscopic tissue inflammatory changes in the study group was significantly lower than that in the control group [(2.98±0.66) points vs. (4.07±0.66) points, P < 0.05], the expression of IL-18 and NAG in the study group was lower than that in the control group in immunohistochemistry. There were no significant differences in cold perfusion/renal artery occlusion time, body temperature, operation time and postoperative hospital stay between the two groups (all P>0.05).  Conclusion  LPN combined with modified renal artery perfusion can reduce blood loss, reduce inflammation and protect renal function in the treatment of complex renal tumors.

     

    • FullText(HTML)
  • loading
    • References(22)
  • [1]
    KLETT E D, TSIVIAN M, PACKIAM V T, et al. Partial versus radical nephrectomy in clinical T2 renal masses[J]. Int J Urol, 2021, 28(11): 1149-1154. doi: 10.1111/iju.14664
    [2]
    王庆军. 分析腹腔镜下保留肾单位手术与开放手术治疗肾肿瘤的疗效及对术后并发症发生情况的影响[J]. 中国实用医药, 2021, 16(13): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202113016.htm

    WANG Q J. To analyze the efficacy of laparoscopic nephron sparing surgery and open surgery in the treatment of renal tumors and the influence of postoperative complications[J]. Chinese Journal of Practical Medicine, 2021, 16(13): 61-63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA202113016.htm
    [3]
    YU Y, WANG W F, XIONG Z Q, et al. Comparison of perioperative outcomes between laparoscopic and open partial nephrectomy for different complexity renal cell carcinoma based on the R.E.N.A.L. nephrometry score[J]. Cancer Manag Res, 2021, 13: 7455-7461. doi: 10.2147/CMAR.S324457
    [4]
    邱敏, 宗有龙, 王滨帅, 等. 腹腔镜肾部分切除术治疗R.E.N.A.L. 评分10分肾肿瘤的可行性[J]. 中华泌尿外科杂志, 2022, 43(5): 339-343. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJCW202102021.htm

    QIU M, ZONG Y L, WANG B S, et al. Feasibility of laparoscopic partial nephrectomy for treatment of renal tumors with R.E.N.A.L. score of 10[J]. Chinese Journal of Urology, 2022, 43(5): 339-343. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJCW202102021.htm
    [5]
    DUBEUX V T, ZANIER J F C, GABRICH P N, et al. Practical evaluation of the R.E.N.A.L. score system in 150 laparoscopic nephron sparing surgeries[J]. Int Braz J Urol, 2022, 48(1): 110-119. doi: 10.1590/s1677-5538.ibju.2021.0424
    [6]
    ZINSSIUS D, JVNEMANN K P, GEIGER F, et al. Evaluation of the Padua and R.E.N.A.L. scores regarding their validity and implication in the perioperative management during partial nephrectomy[J]. Aktuelle Urol, 2022, 53(5): 423-430. doi: 10.1055/a-0888-7234
    [7]
    KEUM K H, YOUNG K J, DEUK C Y, et al. Effect of combined treatment of ketorolac and remote ischemic preconditioning on renal ischemia-reperfusion injury in patients undergoing partial nephrectomy: pilot study[J]. J Clin Med, 2018, 7(12): 470. doi: 10.3390/jcm7120470
    [8]
    BAHADORAM S, DAVOODI M, HASSANZADEH S, et al. Renal cell carcinoma: an overview of the epidemiology, diagnosis, and treatment[J]. G Ital Nefrol, 2022, 39(3): 2022-vol3.
    [9]
    吴明哲, 潘浩杰, 周安安, 等. 铁死亡调控的关键因子在肾癌中的研究进展[J]. 中国医药, 2023, 18(3): 472-476. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202303033.htm

    WU M Z, PAN H J, ZHOU A A, et al. Research progress of key factors regulating iron death in renal carcinoma[J]. Chinese Journal of Medicine, 2023, 18(3): 472-476. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202303033.htm
    [10]
    高五岳, 郭园园, 刘贝贝, 等. 不同距离癌旁组织PD-1和PD-L1表达对肾部分切除术边距选择的临床意义[J]. 中华全科医学, 2019, 17(12): 2004-2007, 2034. doi: 10.16766/j.cnki.issn.1674-4152.001113

    GAO W Y, GAO Y Y, LIU B B, et al. Clinical significance of expression of PD-1 and PD-L1 in paracancer tissues at different distances in selection of margin for partial nephrectomy[J]. Chinese Journal of General Practice, 2019, 17(12): 2004-2007, 2034. doi: 10.16766/j.cnki.issn.1674-4152.001113
    [11]
    BERTOLO R, AUTORINO R, SIMONE G, et al. Outcomes of robot-assisted partial nephrectomy for clinical T2 renal tumors: a multicenter analysis (ROSULA Collaborative Group)[J]. Eur Urol, 2018, 74(2): 226-232. doi: 10.1016/j.eururo.2018.05.004
    [12]
    过菲, 张超, 王富博, 等. 机器人辅助腹腔镜肾肿瘤精准剜除术治疗复杂内生性中央型肾窦部肿瘤的初步体会[J]. 中华泌尿外科杂志, 2019, 40(5): 346-350. doi: 10.3760/cma.j.issn.1000-6702.2019.05.006

    GUO F, ZHANG C, WANG F B, et al. Treatment of complex endoplastic central renal sinus tumors by robot-assisted laparoscopic precision enucleation[J]. Chinese Journal of Urology, 2019, 40(5): 346-350. doi: 10.3760/cma.j.issn.1000-6702.2019.05.006
    [13]
    LONGBING X, JANE K J, YULU P, et al. What happens to the preserved renal parenchyma after clamped partial nephrectomy?[J]. Eur Urol, 2022, 81(5): 492-500. doi: 10.1016/j.eururo.2021.12.036
    [14]
    刘傲璐, 李壮, 卢美芝, 等. 新型磷酸二酯酶5抑制剂CPD1对单侧肾缺血再灌注损伤后肾间质纤维化的影响[J]. 生理学报, 2023, 75(1): 1-9. https://www.cnki.com.cn/Article/CJFDTOTAL-SLXU202301001.htm

    LIU A L, LI Z, LU M Z, et al. Effect of phosphodiesterase 5 inhibitor CPD1 on renal interstitial fibrosis after unilateral renal ischemia reperfusion injury[J]. Acta Physiologica Sinica, 2023, 75(1): 1-9. https://www.cnki.com.cn/Article/CJFDTOTAL-SLXU202301001.htm
    [15]
    韩成, 刘瑀, 吴圆圆, 等. 促红细胞生成素受体在缺血再灌注所致急性肾损伤和修复或纤维化中的作用及机制[J]. 生理学报, 2023, 75(1): 115-129. https://www.cnki.com.cn/Article/CJFDTOTAL-SLXU202301013.htm

    HAN C, LIU Y, WU Y Y, et al. The role of erythropoietin receptor in acute renal injury, repair and fibrosis induced by ischemia reperfusion[J]. Acta Physiologica Sinica, 2023, 75(1): 115-129. https://www.cnki.com.cn/Article/CJFDTOTAL-SLXU202301013.htm
    [16]
    MALIK A, OMAR A, HASSAN A, et al. Laparoscopic partial nephrectomy: off-clamp versus on clamp[J]. Asian Pac J Cancer Prev, 2022, 23(5): 1719-1723.
    [17]
    HERNANDO M S, GONZALO V, ANDRÉS G H. Effectiveness and safety of partial nephrectomy-no ischemia vs. warm ischemia: systematic review and meta-analysis[J]. Investig Clin Urol, 2020, 61(5): 464-474.
    [18]
    LU Q, ZHAO X Z, JI C W, et al. Functional and oncologic outcomes of robot-assisted simple enucleation with and without renal arterial cold perfusion in complex renal tumors: a propensity score-matched analysis[J]. BMC Urology, 2021, 21(1): 2.
    [19]
    LIU F, YUAN H, LI X, et al. Application of hypothermic perfusion via a renal artery balloon catheter during robot-assisted partial nephrectomy and effect on renal function[J]. Acad Radiol, 2019, 26(8): e196-e201.
    [20]
    BAI Y C, YANG Y K, WEI H B, et al. Clinical outcomes of robotic-assisted laparoscopic partial nephrectomy with renal hypothermia perfusion by renal artery balloon catheter in treating patients with complex renal tumors[J]. Front Oncol, 2022, 12: 918143. DOI: 10.3389/fonc.2022.918143.
    [21]
    孙凡皓, 于红, 殷波. 经尿道前列腺切除术患者发生术中低体温的危险因素[J]. 中国医科大学学报, 2022, 51(12): 1121-1125. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYK202212012.htm

    SUN F H, YU H, YIN B. Risk factors of intraoperative hypothermia in patients undergoing transurethral prostatectomy[J]. Journal of China University of Medical Sciences, 2022, 51(12): 1121-1125. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYK202212012.htm
    [22]
    刘亚东, 张艳, 田慧珍. 新型急性肾脏损伤标志物的研究进展[J]. 中国临床研究, 2018, 31(6): 852-855. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201806041.htm

    LIU Y D, ZHANG Y, TIAN H Z. Study on novel markers of acute kidney injury[J]. Chin J Clinical Research, 2018, 31(6): 852-855. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK201806041.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (179) PDF downloads(12) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return