Clinical Study On The Effect Of Warm Ischemia Time On Postoperative Renal Function After Laparoscopic Partial Nephrectomy In Xining Area

Objective: To investigate the influence of warm ischemic time on early postoperative renal function during laparoscopic partial nephrectomy in xining area,and to define the safe range of warm ischemic time in kidney Methods: A retrospective analysis was performed on the clinical data of 45 patients admitted to the department of urology of the affiliated hospital of qinghai university from September 2017 to November 2018 for renal tumor and who met the inclusion and exclusion criteria.All cases were divided into two groups according to the length of intraoperative warm ischemia time.Group A(13 cases)had a warm ischemia time greater than 30 minutes;Group B(32 cases)had a warm ischemia time of 30 minutes or less.To observe and compare the effects of different warm ischemia time on serum creatinine,blood urea nitrogen and glomerular filtration rate at the third month after surgery.Finally,the safe range of renal warm ischemia time was determined by statistical analysis.Results:(1)The operation was successful in 45 patients,who were not transferred to open surgery.There was no statistically significant difference in preoperative gender,ethnicity and other counting data between the two groups(P<0.05).There were no statistically significant differences in preoperative serum creatinine,glomerular filtration rate and other measurement data between the two groups(P<0.05).(2)The serum creatinine level of the two groups increased at the third month after surgery compared with that of the same group(P>0.05).The increase of serum creatinine in group A was higher than that in group B.There was no significant difference between the two groups(P>0.05).(3)The blood urea nitrogen level of the two groups decreased at the third month after surgery compared with the same group(P>0.05).The decrease of serum creatinine in group A was higher than that in group B.There was no significant difference between the two groups(P>0.05).(4)The operated-side renal GFR in the 3rd month after operation was lower than that in the same group(P<0.001).The decrease of the operated-side renal GFR in group A was higher than that in group B,and the difference between the two groups was statistically significant(P < 0.05).The total renal GFR in the 3rd month after operation was lower than that in the same group(P<0.001).The decrease of the total renal GFR in group A was higher than that in group B,and the difference between the two groups was statistically significant(P < 0.05).Conclusions: 1.In xining area,the warm ischemic time during laparoscopic partial nephrectomy should be controlled within 30 minutes as far as possible,and the warm ischemic time of the kidney should be less than or equal to 30 minutes,which had obvious advantages for the recovery of early postoperative renal function.2.After laparoscopic partial nephrectomy in xining area,ECT should be used to evaluate postoperative renal function,It is unscientific to use blood creatinine and blood urea nitrogen to evaluate early postoperative renal function.