| Object To evaluate the changes of renal function after Laparoscopic radical nephrectomy(LRN)and the factors affecting postoperative renal function.Method The clinical data of patients with renal cell carcinoma undergoing laparoscopic radical nephrectomy were collected from January 1,2014 to August 31,2016,after the urology of Xiamen First Hospital.The data include gender,age,history of hypertension,history of diabetes mellitus,tumor location,tumor diameter,tumor type,tumor stage,tumor grade,preoperative creatinine level,ipsilateral GFR,contralateral GFR,total GFR and so on.(GFP)was used to calculate the GFR(estimated GFR,e GFR)instead of GFR,and e GFR [ml ? min-1 ?(1.73m2)-1] = 186 *(1.32 * Scr-0.20)-1.154 * [age]-0.203 * [female * 0.742] * [Chinese people * 1.233],to three consecutive times e GFR <60ml /(min ? 1.73m2)to determine chronic renal dysfunction(chronic dysfunction,CKD).Through the SPSS22.0 software,using t test,rank sum test,chi-square test analysis variables.The factors influencing CKD were analyzed by univariate and multivariate logistic regression analysis.P <0.05 when the difference was statistically significant.Results Atotal of 59 patients were included in this study,the postoperative pathology was diagnosed as renal cell carcinoma.The mean follow-up was 5.18 ±3.02 months.The overall age distribution of 21 to 77 years old,of which 36 cases of male patients,23 cases of female patients.13 patients with hypertension,3 patients with diabetes,the average tumor diameter of 6.08 ± 3.25 cm.In this 59 cases,there were 21 cases of CKD,38 cases of CKD did not occur.The average age of CKD group was 55.57 ± 11.46 years old,13 cases(61.9%)and 8 cases(38.1%),including 6 cases(28.57%)of hypertension,1 case of diabetes(4.76%),4 cases of smoking(28.58%),14 cases(66.67%)in T1 stage,6 cases(28.57%)in T2 stage,16cases(28.58%)with T1,,T3 in 1 case(4.76%),preoperative serum creatinine range of 80.38 ± 20.41 nmol / L.The average age of CKD group was 51.44 ± 13.23years old,24 cases(63.16%)and 14 cases(36.84%),including 7 cases(18.42%)of hypertension,2 cases of diabetes(5.26%),9 cases of smoking(23.68%),the largest diameter of the tumor 6.35 ± 3.64 cm,clear cell carcinoma in 28 cases(73.68%),other types of tumors in 10 cases(26.32%).T1 was 26 cases(68.42%),T2 in 9 cases(23.68%),T3 in 3 cases(7.89%).Preoperative serum creatinine range was 66.76 ±21.85 nmol / L.There was no significant difference in age,sex,hypertension,diabetes,smoking,tumor maximal pathology,pathological type,tumor stage and tumor grade(P> 0.05).Preoperative creatinine levels were statistically significant(P <0.05).Multivariate logistic analysis show that Preoperative contralateral GFR(P = 0.036,OR = 1.107)?e GFR(P = 0.023,OR = 1.129)on day 1 postoperatively?e GFR(P = 0.011,OR = 1.1206)on day 2 postoperatively.was the risk factors for prognosis.Conclusion 1.LRN postoperative renal function was temporarily increased.2.The prognostic factors of renal function were Preoperative contralateral GFR?e GFR level on day 1 and day 2 after operation. |
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