The Comparative Study Of Laparoscopic Partial Nephrectomy And Laparoscopic Nephrectomy In Miniature Pigs

Since laparoscopic techniques used in the treatment of kidney disease, rapid development,there appeared the laparoscopic nephrectomy, laparoscopic partial nephrectomy and other surgical procedures, surgical methods, such as the establishment of the surgery path way had been more varied. However, existing research for nephrectomy and laparoscopic partial nephrectomy effects on the body had much controversy, the relation of preserved renal unit quantity and kidney damage was less researched.This experiment was to study the similarities and differences of laparoscopic nephrectomy and 1/2 laparoscopic partial nephrectomy and 2/3 laparoscopic partial nephrectomy, and discussed the influence of preserved renal unit quantity to the body, provided evidence for two kinds of surgery in the clinical application and promotion.12 bama miniature pigs were used in this study. They were divided into four clusters: blank control group(A), 1/2 left laparoscopic partial nephrectomy(B), 2/3 left laparoscopic partial nephrectomy(C),left laparoscopic simple nephrectomy(D).Except surgical methods, other conditions were same. Normal physiological indexes, inflammatory reaction, oxidative stress,liver function, renal function of experimental animal were detected in pre-operate(Q), immediate postoperative(H), 1d, 2d, 3d, 5d, 7d, 14 d after operation.The results are as follows:(1)30d after operative exploration: 1/2 left laparoscopic partial nephrectomy group recovered well; 2/3 left laparoscopic partial nephrectomy kidney was covered by the surrounding tissues serious and even produce pus cavity, don’t have the renal function. In the influence on normal physiological indexes,2/3 left laparoscopic partial nephrectomy all indicators had more differences in immediate postoperative,compared to pre-operate and heart rate increased significantly 7d after surgery(0.01<P<0.05);the blood pressure of simple nephrectomy group increased significantly 2d after surgery(0.01<P<0.05).(2)In impact on inflammatory reaction, four groups experimental animals WBC, IL- 6, COR tend to reduce after the first rise, but the recovery speed blank control group> simple nephrectomy group > 1/2 left laparoscopic partial nephrectomy group > 2/3 left laparoscopic partial nephrectomy group. At the same time point group data between two comparison, 2/3 laparoscopic partial nephrectomy group> 1/2 left laparoscopic partial nephrectomy group > t simplenephrectomy group > blank control group. In the impact on the oxidative stress, 1/2 left laparoscopic partial nephrectomy group, 2/3 laparoscopic partial nephrectomy group GSH-PX and SOD levels were lower,and MDA level were higher than other two groups.(3)In the impact on liver function, four groups had no difference in ALT, AST level(P>0.05).In the influence on renal function,2/3 left laparoscopic partial nephrectomy group levels rised quickly and postoperative renal injury were higher than the other three groups; 1/2 left laparoscopic partial nephrectomy group postoperative kidney injury markers level higher than that of the simple nephrectomy groups at first, then below to the simple nephrectomy groups.Results showed:(1)Laparoscopic nephrectomy operation and 1/2 partial nephrectomy are safe and feasible in clinical application. 2/3 partial nephrectomy has high percent of postoperative complications risk.(2)Compare to two types laparoscopic partial nephrectomy, laparoscopic nephrectomy operation time is short, has less abdominal cavity adhesion, and has slight effects on the body.(3)Compared to laparoscopic nephrectomy, 1/2 partial nephrectomy can keep nephron function, is advantageous to the renal function recovery, 2/3 left laparoscopic partial nephrectomy couldn’t keep the function of renal unit, but also had harmful to other function of body.