CTU联合CTA与术中超声在小肾癌经腹腔镜肾部分切除术中的应用价值OA

Objective:To explore the clinical application value of the combined application of preoperative computed tomography urography(CTU)and computed tomography angiography(CTA),supplemented by intraoperative ultrasound examination,in retroperitoneal laparoscopic partial nephrectomy for small renal cell carcinoma.Method:A total of 68 patients with small renal cell carcinoma who received retroperitoneal laparoscopic partial nephrectomy in Shandong Provincial Corps Hospital of the Chinese People's Armed Police Force from February 2018 to May 2019 were selected as the research objects.They were divided into groups according to different preoperative examination schemes.Among them,35 patients who only underwent CTA examination before surgery were included in the control group,and 33 patients who received combined CTU and CTA examination before surgery and were supplemented with intraoperative ultrasound were included in the observation group.The surgical related indicators,renal function related indicators,complication occurrence and the rate of intraoperative conversion to open surgery were compared and analyzed between the two groups.Result:The intraoperative blood loss of patients in the observation group was significantly less than that in the control group;the total intraoperative operation time,intraoperative exploration time of target artery,postoperative drainage tube removal time,intraoperative warm ischemia time and postoperative hospital stay in the observation group were all shorter than those in the control group,and the differences between the two groups were statistically significant(P<0.05).Postoperative follow-up found that the levels of blood urea nitrogen(BUN),creatinine(Cr)and glomerular filtration rate(GFR)in the observation group were all higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was much lower than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the rate of intraoperative conversion to open surgery between the two groups(P>0.05).Conclusion:In the clinical process of retroperitoneal laparoscopic partial nephrectomy for small renal cell carcinoma,the examination scheme of preoperative CTU,CTA combined with intraoperative ultrasound can achieve significant clinical application and therapeutic effects.This combined examination scheme can clearly show the running characteristics of renal blood vessels,realize rapid and accurate localization of tumor tissue,effectively reduce the damage to patients'renal function caused by surgical operations,maximize the retention of normal renal units,reduce the risk of postoperative complications,and at the same time reduce the occurrence of intraoperative conversion to open surgery,further improve the safety and stability of surgical implementation.