Diameter-Axial-Polar System In Laparoscopic Nephron Sparing Surgery

Object: To evaluate the effictiveness of Diameter-Axial-Polar System.Methods: 52 patients who underwent LNSS for small renal cell carcinoma from 2012 to June 2015 in the Jining medical college affiliated hospital were entered this retrospective analysis.nephron-sparing surgery were performed in the other 24 patients. We collected clinical data to estimate the clinical effect of LNSS, including the tumor size, operation time, ischamia time,intraoperative blood loss, postoperative drainage, the drainage tube indwelling time, postoperative hospital stay,complications.Result:Patients were performed in this paper a LNSS surgery.DAPScore 3to 9 points, the average 5±1.46 points, WIT for 18 to 53 min, an average of 25±9.78 min, the operation time of 33-205 min, an average of 117.90±42.70 min, surgical blood loss 5-200 ml, an average of 43.55 ± 49.57 ml,postoperative of 28-803 ml, an average of 228.31±156.21 ml, postoperative1-18 days of such confinement, an average of 6.82±2.28 days.In patients with postoperative complications of 5 cases, including 1 case with postoperative leakage, healing after conservative treatment, renal week 2 cases of infection,fever, chills, give antibiotic resistance to infection healed after treatment, lower extremity deep vein thrombosis, muscular venous thrombosis in 2 cases, 1healed after thrombolysis treatment.Postoperative pathological back in 23 cases of clear cell carcinoma(45%), angiomyolipomas 15 cases(29%), 8 cases toocolor cell carcinoma(16%), papillary carcinoma, 2 cases(4%), 1 case of spindle cell carcinoma(4%), acidophilic cell carcinoma in 1 case(4%), 1caldfication fiber(4%).DAP System and operation time(P = 0.016), WIT(P <0.001), intraoperative blood loss(P = 0.022)were significantly related,no significant relationship with the length of time.Conclusion:DAP scoring system comprehensive evaluation score to anatomical characteristics of renal tumor, has certain prediction effect to perioperative outcome, but still need further study to evaluate the clinical application value.