The Application Of Laparoscopic Partial Nephrectomy Assisted By Ultrasonic For Totally Intrarenal Tumors

Objective:To explore the feasibility of laparoscopic partial nephrectomy for totally intrarenal type of renal tumors assisted by laparoscopic ultrasound.Methods:There were 22 patients withrenal tumorcompleted by the same surgical team of Fujian provincialhospital from March 2015 to March 2017,22 of which were treated by laparoscopic partial nephrectomy assisted by laparoscopic ultrasound.15 cases were male,7 cases were female,15 cases were on the lelf(male(n=10),female(n=5));7 cases were on the right(male(n=4)female(n=3)).6 patients suffer from high blood pressure,2 cases suffer from diabetes mellitus.Mean age was 45.8 ± 13.4 years,body mass index(bmi)in 23.7 kg / ㎡.The mean tumor diameter 1.1-4.8 cm,2.53 ± 1.34 cm.The mean RENAL score Of these tumor was 8.59±1.18(7-11).Results: 22 patients underwent laparoscopic partial nephrectomy,1 case converted to radical nephrectomy.The average of operation time was 228.3 ±71.2 min,average intraoperative blood loss was 152.7 ±194.8 ml,average renal artery ischemia time was 28.6min.There are 3 cases presented with hematuria,2 of which improved with conservative treatment,1 of which was diagnosed with arterial aneurysm by highly selective renal artery embolism.The average of hospitalization days stay 8.6d.Preoperative renal GFR was 51.4±11.8ml/min,6 months postoperative renal GFR was 36.5±7.7 ml/min.There were no recurrence or metastasis within 3 to 24 monthsfollow-up Postoperative。Conclusions: the application of laparoscopic ultrasound contributes to intraoperative position for the totally intrarenal type of renal tumors,greatly reduces the difficulty of surgical which the totally intrarenal type of renal tumors underwent operation,reducing the unnecessary renal resection,and the complication of postoperation are low incidence.