The Study Of Complications Of Retroperitoneal Laparoscopic Partial Nephrectomy For Renal Cell Carcinoma In Early Stage

Objective:In order to explore the posterior abdominal laparoscopic partial nephrectomy for the treatment of early renal tumor complications,to evaluate the safety and efficacy of the procedure for the clinical treatment of early renal tumor surgery to provide a reference.Methods:We had collected a total of 22 patients with retroperitoneal laparoscopic partial nephrectomy in treatment of kidney tumor of the 175 th Hospital of PLA Department of Urology from February 2014 to June 2016.Male 16 cases,female 6 cases;average age(25~62)44.2 years old;The tumor size ranged from 0.4 cm to 1.7 cm *2.6 cm to5.5 cm,average size 1.1cm * 3.7cm,All patients were diagnosed with CT before operation,or ECT was performed in some patients according to the level of serum creatinine,and measuring the maximum diameter of the tumor was measured.Screening cases in strict accordance with the inclusion criteria and exclusion criteria,The operative time,blood loss,blood transfusion rate,warm ischemia time,intraoperative complications,perioperative period,postoperative complications,follow-up of renal function recovery and survival were were recorded,To evaluate the security and curative effect of retroperitoneal laparoscopic partial nephrectomy in treatment of kidney tumor.Results:operation: All operations were completed successfully,nobody conversion to open surgery.The average operation time was 117.3(range,90 ~ 152)min.The average warm ischemia time was 28.5(range,20 ~ 38)min.The average intraoperative blood loss was 267.7(range,200 ~ 400)m l,Intraoperative blood transfusion occurred in 1 patient.All successful removal of the catheter and flow by postoperative.pathological examination results: Clear cell carcinoma in 14 patient(tumor surface adipose tissue infiltration in 1 patient、tumor cell infiltration in 2patients);Renal angiomyolipoma in 5 patients;Papillary renal cell carcinoma in 3 patients;False capsule rupture in 1 patient.Follow-up:19 patients were followed up after discharge,The average follow-up time was 11(range,3~20)months,Renal function returned to normal third days after hospitalization in 15 patients,renal insufficiency in 2 patients in following six months to 1 years,Lung metastasis in 1patient,no deaths reported.Complications:Retroperitoneal rupture in 3 patients;renal vascular traction injury in 1 patient;A small amount of blood oozing after release of vascular clamp in 3 patients,all patients had postoperative pain in the incision,Subcutaneous emphysema in 3 patients.Pulmonary infection in 2 patients.Conclusion:The use of retroperitoneal approach laparoscopic partial nephrectomy for the treatment of early renal tumors,with dissection free quickly,time-consuming shorter,the advantages of light interference to the gastrointestinal function.To ensure the efficacy of surgery at the same time,did not increase intraoperative bleeding,postoperative leakage of urine,renal insufficiency,renal tissue injury and other complications such as complications,further confirmed by retroperitoneal approach laparoscopic partial nephrectomy early renal neoplasms are safe and effective.