Comparative study on the curative effect of laparoscopic nephron sparing surgery and renal functions under selective segmental renal artery clamping and main renal artery clamping

• Published in: Pakistan journal of medical sciences Vol. 36; no. 2; pp. 121 - 125
• Main Authors: Liu, Yuan-Hua, Dai, Hai-Tao, Liu, Chang-Mao, Wang, Zhong-Yu, Zheng, Jiang
• Format: Journal Article
• Language: English
• Published: Pakistan Knowledge Bylanes 01.01.2020; AsiaNet Pakistan (Pvt) Ltd; Professional Medical Publications
• Subjects: Comparative analysis; Comparative literature; Death; Infections; Ischemia; Laparoscopy; Metastasis; Original; Statistical analysis; Surgery; Technology; Time; Tumors; Veins & arteries; Warm ischemia; LNSS; MRAC; Renal function; T1 localized renal tumor; SSRAC
• ISSN: 1682-024X; 1681-715X
• DOI: 10.12669/pjms.36.2.1505

To discuss the clinical effect and safety evaluation of laparoscopic nephron sparing surgery (LNSS) under selective segmental renal artery clamping (SSRAC) and main renal artery clamping (MRAC). Eighty-four patients with T1 localized renal tumors who were admitted and treated from October 2017 to October 2018 were retrospectively analyzed, and they were classified into the S group (42 patients) and M group (42 patients). The patients in the S group received LNSS under SSRAC, while the patients in the M group received LNSS under MRAC. The duration of the operation, amount of intraoperative blood loss, intraoperative warm ischemia time, duration of postoperative hospital stay and positive rate of incisal edge; the serum creatinine and blood urea nitrogen values before and after the operation; and the occurrence rates of intraoperative and postoperative complications were compared. All operations were completed smoothly. No patients had a positive incisal edge, and no patients were converted to MRAC during the operation. The duration of the operation and the amount of intraoperative blood loss increased in the S group compared with the M group. The differences were statistically significant (P <0.05). The differences in the intraoperative warm ischemia time, postoperative drainage and duration of postoperative hospital stay in both groups had no statistical significance (P >0.05). The differences in serum creatinine (SCr) and blood urea nitrogen (BUN) in both groups before the operation had no statistical significance (P >0.05). The SCr and BUN levels significantly increased 1 d and 1 m after the operation. The SCr and BUN levels 1 d and 1 m after the operation were significantly lower in the S group than in the M group, and the differences were statistically significant (P <0.05). The differences in the occurrence rates of intraoperative and postoperative complications in both groups had no statistical significance (P >0.05). SSRAC is a new renal artery clamping technology, and its curative effect on LNSS patients is significant. In addition, SSRAC has high safety and little influence on renal functions.