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The efficacy evaluation of partial nephrectomy with selective renal artery branch occlusion by laparoscopy
Chun-Hui Wang1, Chun-Sheng Li1, Ying Jiang2
1Department of Urology, Affiliated Hospital of Chifeng University, No. 42 Wangfu Street, Chifeng, Inner Mongolia, China.
Background:
To investigate the clinical application and effect of laparoscopic partial nephrectomy with renal artery branch occlusion in the treatment of early renal tumors.
Methods:
A retrospective analysis was conducted on the clinical data of 15 cases of renal tumor patients who underwent partial nephrectomy by laparoscopic selective renal artery branch occlusion in our department from January 2017 to January 2018. Nine male patients and 6 female patients were aged 46 to 65 years, with an average age of 54.3 ± 7.2 years. The diameters of tumors were 2.2 to 4.0 cm, with an average of 3.3 ± 0.7 cm. There are 10 tumors locating on the left side and 5 on the right side. Preoperative renal glomerular filtration rate (GFR) were 77.3 to 61.9 mL/min with an average of 47.6 ± 7.5 mL/min. All patients' diseased kidneys underwent renal computer tomography angiography examination before surgery. And the diseased kidney underwent reexamination of renal GFR. The operation time, renal artery branch occlusion time, intraoperative blood loss, postoperative hospital stay, changes of renal function, and complications were evaluated.
Results:
All surgery were completed successfully, the surgery time was 136.7 ± 15.2 min, intraoperative renal artery branch occlusion time was 21.3 ± 4.5 min, the intraoperative blood loss was 223.3 ± 69.5 mL, the postoperative hospital stay was 6.5 ± 1.7 days, and the postoperative 1-month GFR was 49.5 ± 6.6 mL/min. There was no significant difference between the renal GFR before and after surgery (P > .05). There was no blood transfusion and transfer open surgery cases. The patients were followed up for 3 to 15 months without complications.
Conclusions:
Partial nephrectomy with selective renal artery branch occlusion by laparoscopy is a safe, feasible, and effective method for the treatment of early renal cancer. It makes good use of the technical advantages of clear operation field and fine operation of laparoscopic surgery, avoids the heat ischemia process of the whole kidney, and can better protect the renal function.
Insights
Laparoscopic partial nephrectomy using renal artery branch occlusion is a safe and effective treatment for early renal tumors. This minimally invasive approach preserves renal function and avoids whole-kidney ischemia.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Early-stage renal tumors present a clinical challenge for effective treatment while preserving kidney function.
- Laparoscopic partial nephrectomy (LPN) is a preferred surgical approach for localized renal masses.
- Selective renal artery branch occlusion offers a targeted ischemia strategy during LPN.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of LPN with selective renal artery branch occlusion for early renal tumors.
- To assess the impact of this technique on renal function and postoperative outcomes.
Main Methods:
- Retrospective analysis of 15 patients undergoing LPN with selective renal artery branch occlusion.
- Patients aged 46-65 years with tumor diameters ranging from 2.2-4.0 cm.
- Preoperative and postoperative renal function (Glomerular Filtration Rate - GFR) assessed, along with surgical parameters and complications.
Main Results:
- All 15 procedures were completed successfully with an average operative time of 136.7 minutes.
- Average renal artery branch occlusion time was 21.3 minutes, with minimal blood loss (223.3 mL).
- Postoperative GFR showed no significant difference from preoperative levels, and no major complications were reported during 3-15 months follow-up.
Conclusions:
- Laparoscopic partial nephrectomy with selective renal artery branch occlusion is a safe, feasible, and effective treatment for early renal cancer.
- This technique leverages laparoscopic advantages for precise surgery and better renal function preservation.
- It effectively avoids prolonged whole-kidney ischemia, contributing to favorable functional outcomes.
