| Section 1 Application of 3D Laparoscopic in Kidney Disease SurgeryObjective:To preliminary explore the 3D laparoscopic techniques in t-he application of surgical treatment in kidney disease,and to compare the efficacy of 3D and 2D laparoscopic partial nephrectomy.Methods: From Mar. 2013 to Oct. 2013,a total of 52 cases of laparoscopic surgery were completed by using 3D laparoscopy system.Those included 20 cases of radical nephrectomy,16 cases of partial nephrectomy,12 cases of simple nephrectomy,4 cases of nephro-ureterectomy,and we chose 20 cases of 2D laparoscopic partial nephrectomy. B-ultrasound, IVU,CT or MRI were performed before operation in all cases; and renal function were within the normal range, ipsilateral kidney had non-function. Malignant renal neoplasm were all T1-T2N0 MO.Results: All operations were succeeded and effective. the operation time of 50-130 min, with the time of radical nephrectomy of 60-110 min, partial nephrectomy of 65-100 min, simple nephrectomy of 50-90 min,nephro-ureterectomy of 60-130 min,the time of renal pedicle clamping of partial nephrectomy surgery was 14 ~ 25 min,an average of 16.2 min,the blood volume was 60-350 m L.And the postoperative hospital time was 5~9d with an average of 6d. Operation time, renal warm ischemic time and intraoperative bleeding volume in the 3D laparoscopic group were significantly more than those in the control group, there was significant difference(P<0.05), the age, tumor size, poslopemtive hospital time,the time of recovery of bowel function had no obvious difference(P>0.05). In the 3D laparoscopic group,pathological diagnosis showed nephroblastoma in 1 patient, papillary carcinoma in 1,angioleiomyolipoma in 6,clear cell carcinoma in 28,ureter urothelial carcinoma in 4,nephrotuberculosis in 2,atrophickidney in 10,and in control group, angioleiomyolipoma in 3,others were clear cell carcinoma. All patients did not receive blood transfusion and had no obvious complication. Follow-up of 1-7 months, we have not found any local relapse and tumor seeding of the incision site.Conclusion: 3D laparoscopic technology can provide anatomical layering similar to open surgery.Anatomy is more accurate and the suture is relatively easy compared with traditional laparoscopic.The system has the advantages of both laparoscopic and open surgery,and will have a good prospect in the urologic clinical practice.Section two Effects of CO2 Pneumoperitoneum on Plasma VEGF and PDGF-BB.Objective :To compare the efficacy of 3D and 2D laparoscopic radical nephrectomy,and to probe the effect of CO2 Pneumoperitoneum on plasma VEGF and PDGF-BB.Methods: We retrospectively analyzed 36 cases(from Nov.2012 to Jul.2014) of laparoscopic radical nephrectomy.24 cases accept 3D laparoscopic radical nephrectomy and 12 cases radical nephrectomy.There were 25 males and 11 females,25-79 years old,averaged age 48.3±10.7.B-ultrasound, IVU,CT or MRI were performed before operation in all cases; and renal function were within the normal range. Malignant renal neoplasm were all T1-T3N0 MO. Blood samples were taken preoperatively(T1) and at the end of the surgery(Within 24 hours(T2)、3 days(T2) and 7 days(T4) after the operation). VEGF and PDGF-BB levels in blood plasma of all patients were observed by ELISA.The following parameters were measured and compared within each group and between groups by a statistical soft system SPSS 17.0.Results: All operations were succeeded and effective.Operation time, intraoperative bleeding volume,poslopemtive hospital time and the time of recovery of bowel function in the 3D laparoscopic group were significantly more than those in the control group, there was significant difference(P<0.05), the age, tumor size, renal function(serum Cr) had no obvious difference(P>0.05).The levels of PDGF – BB in 3D laparoscopic groupin T2, T3,T4 and T1 comparative differences were statistically significant(P < 0.05), there was no statistically significant difference between the T2, T3, and T4. The levels of PDGF – BB in 3D laparoscopic group in T2 and T1 comparative differences were statistically significant. there was no statistically significant difference between others.Conclusion :1. 3D laparoscopic technology can provide anatomical layering similar to open surgery.Anatomy is more accurate and the suture is relatively easy compared with open surgery. 2.. The degree of the effects in VEGF and PDGF- BB was no significant difference compare to those in open radical nephrectomy. |
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