The Clinical Application Of Superselective Renal Artery Clamp In Partial Nephrectomy

Objective:To study the clinical effect of reducing the renal injury of selective renal artery clamp in partial nephrectomy, and to study the effects of various techniques on partial nephrectomy.Methods:A total of 34 patients with T1a-T1b renal tumor were selected from December 2014 to August 2016. Among them, 30 males and 4 females were randomly divided into two groups: the renal artery occlusion : Main renal artery clamp group (N =19 ) , selective renal artery clamp group (n = 15), the two groups were undergoing lower abdominal CT + Enhanced + blood vessel X-ray computed tomography and renal artery CT enhanced angiography + 3D revascularization ( CTU+CTA ) to determine the blood supply of the tumor, SRAC surgery to connect the tumor supply of renal artery and even the second, third.The use of puckle clamp temporarily clamp the renal artery or branch,while surgery by anesthesia appropriate to reduce the average arterial pressure, but to ensure that the body tissue, organ blood supply. The renal function, postoperative renal function, postoperative renal function,postoperative metastasis, and so on were performed in 24 hours after operation, and the data were recorded. Statistical analysis was performed using the SPSS 24.0 software package, all of which were performed by the same experienced physician.Results:All patients underwent surgery were successfully performed in 34 patients. The age,height,body weight, mean tumor diameter,preoperative eGFR and RENAL scores were observed in MRAC group and SRAC group. No statistical difference (P> 0.05).Compared with the MRAC group, the bleeding volume in the SRAC group was more[(197.00±39.00) min vs (154.74±53.16) min,P <0.05],the operation duration was longer [(154.74± 53.16) min vs (120.00 ± 17.05) min (20.86% ± 10.37%) vs (11.88%±14.12),but there was no significant difference between the two groups (P> 0.05),but there was no significant difference (P> 0.05) (P <0.05). However, there was no significant difference in eGFR rate between 3 and 6 months after operation (P> 0.05).There was no significant difference between the two groups after operation.Conclusions:SRAC group in renal partial resection is conducive to partial nephrectomy after renal function recovery, but compared with the MRAC group, increased intraoperative blood loss and prolonged operation time, can not improve postoperative 3 months,June renal function The CTA + CTU can provide partial imaging for renal partial surgery to understand the renal artery anatomy, to determine whether the renal artery mutation, to determine the supply of kidney tumor renal artery branch.