论文部分内容阅读
目的:探讨肾脏肿瘤测量评分系统(R.E.N.A.L评分)在后腹腔镜下肾部分切除术中预测肾脏热缺血时间的应用。方法:回顾性分析2011年1月~2013年3月162例行后腹腔肾部分切除手术(RLPN)患者的临床资料,其中男89例,女73例,年龄24~78岁,平均(55.4±7.5)岁。肿瘤平均直径(3.2±0.8)cm,其中左侧85例,右侧77例;背侧90例,腹侧72例;应用R.E.N.A.L评分系统对肾脏肿瘤进行量化评分。结果:162例患者中,其中低评分组有57例(35%),中评分组有97例(60%),高评分组有8例(5%),低、中与高评分组在肾脏热缺血时间、术中出血量、住院时间均差异有统计学意义(P<0.05),在手术时间、并发症发生率差异无统计学意义(P>0.05)。结论:后腹腔镜下肾部分切除术中高度复杂R.E.N.A.L评分的患者将显著增加肾脏热缺血时间,同时发现术中出血量、住院时间也较中低度复杂者有显著增加;因此R.E.N.A.L评分系统能够较好地评估腹腔镜下肾部分切除术的风险及手术难易程度。
Objective: To investigate the application of the renal tumor measurement scoring system (R.E.N.A.L.Sc.) in predicting the time of warm renal ischemia in retroperitoneoscopic partial nephrectomy. Methods: The clinical data of 162 patients undergoing partial retroperitoneal nephrectomy (RLPN) from January 2011 to March 2013 were retrospectively analyzed. There were 89 males and 73 females, aged from 24 to 78 years (mean, 55.4 ± 7.5) years old. The average tumor size was (3.2 ± 0.8) cm, including 85 on the left and 77 on the right, 90 on the dorsal side, and 72 on the ventral. The kidney tumors were quantified using the R.E.N.A.L scoring system. RESULTS: Of the 162 patients, 57 (35%) were in the low-score group, 97 (60%) in the middle-score group, and 8 (5%) in the high-score group. There were significant differences in the duration of warm ischemia, intraoperative blood loss and hospital stay (P <0.05). There was no significant difference in the incidence of complications during operation (P> 0.05). Conclusions: Patients with highly complex RENAL score in retroperitoneoscopic partial nephrectomy will significantly increase the time of warm ischemia of the kidney, meanwhile, it is found that the intraoperative blood loss and hospital stay are significantly higher than those with moderate or moderate complications. Therefore, the RENAL scoring system Can better assess the risk of laparoscopic partial nephrectomy and surgical difficulty.